How to Get Prescription Discounts (Yes, Even When on Medicare)

There is no question that the cost of prescription drugs in the U.S. is a huge concern and has been for years, particularly among seniors. The cost of medical care in general is pretty high and we all hear that it’s because of the incredible costs involved for research and development that drives it up and up. I am not here to debate all of the reasons why being ill and the cost of doctors, testing, and medicines in 2022 is disastrous; you can figure that out without my words. Instead I am here to tell you about prescription discounts you can use.

Bottle of medication representing prescription discounts

Since I write about savings and think about it personally all the time, I want to focus on how you can get your prescription drugs at a discount. If you thought that was some sort of fantasy, especially if you are on Medicare or Medicaid, you’re wrong. Everyone has some way they can get a deal or a discount if you know how. So right now I am going to share it with you in case you didn’t know.

Those Prescription Discount Cards You See on TV and on the Web

Frequently, you can qualify for a discount on medicines if you are in a certain income group. But I am here to inform you that it’s not always necessary. You can qualify for an easy discount with something you see and hear about all the time!

You know the free cards you see on TV or on the web, GoodRx, SingleCare, WellRx, RxSaver, and others? They are actually terrific ways to get discounts and believe it or not, you can use them to save even if you have Medicare or Medicaid.

It’s a bit confusing at first, but in the end it’s worth investigating and getting real savings. The confusion comes in the wording: You can’t use these discounts in conjunction with Medicare or Medicaid, but you can use them INSTEAD of Medicare or Medicaid even if you have it!

You simply check the best price, one of the discount programs (using the website or app) or your Medicare or Medicaid price, and pick the one you want to use. Then tell your pharmacist to use that discount and price.

Check each time you fill a prescription or reorder, because the prices for Medicare or Medicaid will change depending on when in the year you are ordering. These discounts are especially great when you are in the Medicare “donut hole” and can actually save you hundreds of dollars in some cases.

One caveat, however, is that if you use a prescription discount instead of your insurance, the cost of the prescription will not be counted toward your insurance deductible (if you have one) or toward your progress in or out of the donut hole if you’re on Medicare.

Manufacturer Prescription Discounts

Most manufacturer prescription discounts (such as “co-pay cards”) were created to help privately insured patients afford brand name medication, often when no generic is available. This move helps the patient, but more importantly, it means the manufacturer gets paid by the insurance. For some people, these manufacturer-based drug assistance programs have literally produced longevity and life-saving benefits.

Unfortunately, not everyone qualifies for the assistance. There are rules and guidelines and each manufacturer states what they require. In many instances, these discounts are the best way to get the deepest discount on the drugs you use and need. But typically Medicare and Medicaid enrollees are prevented from using such programs (except in the rarer instances when the manufacturer gives the medication for free).

You can find out directly about these discounts by contacting the manufacturer or searching their website for “patient assistance” or by asking your doctor about them.

You can also find additional patient assistance programs by going to Medicare.gov. Look up each drug you are taking or need to be taking.

Pharmacy Discount Plans

Since the inception of the drug manufacturer assistance programs, pharmacies have followed suit. They began offering discount prescription drug card programs as well. The trend of discount prescription drug cards has somewhat muddied the waters for many consumers seeking to reduce their prescription drug costs, as not all cards are similar.

Prescription drug discount programs are considered private and separate from Medicare plans. And some programs are only available to non-Medicare participants. Therefore, it’s important to read the eligibility requirements of each program. That way, you do not accidentally sign up for a program that will ultimately not provide you any benefits because they do not participate with the Medicare program.

Big Box and Chain Store Programs

Some chain stores with pharmacies like Walmart or Costco, for example, offer discount programs on prescriptions as well. Make sure you understand the rules of pharmacy or department store discount prescription drug cards.

Some pharmacy discount prescription drug cards have eligibility restrictions, i.e., income caps, age limits, or family plans covering children. These types of discount prescription drug cards are usually free.

Other Kinds of Group Discounts

AARP offers discount prescription drug programs (via OptumRx) to its members. However, some programs require you to pay for your membership in order to receive the benefits. There are numerous other special interest groups that offer prescription drug discount programs. For instance, the United Way offers programs in different cities and states that it pairs with private discount card programs. In addition to researching national special interest groups, it would also be helpful to determine whether your state or county offers any prescription drug discount programs.

Checklist for Discount Prescription Drug Plans

  1. Is the card free? If not, what is the charge for the discount card? Is there a one-time charge or is it a recurring monthly/yearly fee?
  2. Where is the card accepted? If the discount prescription drug card is only accepted at particular pharmacies, and there is not one nearby, are you willing to change your pharmacy? Be aware of hidden costs and ask if there are any, such as shipping charges, handling fees, or shipping minimums.
  3. Check to see that the specific drugs you are taking are covered under the discount prescription drug plan in the first place. Determine whether the program also covers generic drugs, even if you are not currently taking any. You may want to have this information for the future.
  4. Always compare costs. If you are choosing a discount program through a retail pharmacy, you should compare the cost of your discounted prescriptions with competing retail pharmacies in your area. If you are dealing with a mail order pharmacy program, make sure that you calculate all of the associated costs, like shipping fees.
  5. Make sure you are eligible for each card you are considering. Only then can you decide which discount prescription drug plan or plans best suit your needs.

More Helpful Hints for Prescription Discounts

Many states offer pharmaceutical assistance programs to those who qualify. Find out if your state has one and inquire about your state’s eligibility requirements. You can find out what assistance is available to you by going to Medicare.gov.

Apply for the Extra Help program from Medicare. Find out if you qualify by contacting your State Medical Assistance (Medicaid) Office or State Health Insurance Assistance Program (SHIP).

People with certain diseases, such as HIV or AIDS or cancer, may also receive assistance in paying for their medications. Go online to your specific disease’s nonprofit organization to find out about assistance programs that may be available to you.

Generic Drugs

Generic drugs can substantially reduce your prescription drug costs. Ask your doctor if there is a generic substitute for your particular prescription medications.

If not, ask your doctor if there is a less expensive brand (or manufacturer) for your prescription drugs. That can also be a money saver.

Mail Order Pharmacies

Consider using mail order pharmacies, especially those provided by your insurer. Just be aware of unknown online prescription drug manufacturers, pharmacies, or companies from other countries. They may provide counterfeit drugs, not be FDA-approved drugs, or contain substandard ingredients and/or harmful contaminates. Ask your doctor to recommend an internet pharmacy before ordering any drugs, brand name or generic, online.

Ask for Free Samples

When you are starting a new medication, always ask the doctor if they have samples available for you to try. It is a waste of money to buy a month’s prescription only to find out after a week that the medicine doesn’t work for you or causes unbearable side effects. By trying the samples first, you don’t need to spend your money until you’re confident that you’ve found the right medication. Your doctor gets these samples from the pharmaceutical reps that sell them, so they don’t get charged and neither should you. They are free.

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Final Thoughts

It’s just a simple fact that as you get older, modern medical science will enter your life in the form of prescription drugs. It’s a good thing of course and it can solve many medical problems and make your life a lot better. But it is also a huge expense and for many unaffordable. That’s why you may have to know as much as you can about prescription discounts and get creative when you do.

It’s not a sign of weakness to try to cut these costs and plan ahead now on how to do it!

Do you use prescription discounts?