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How Can Seniors Save on Prescription Drug Costs?

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With inflation at a record-breaking high, gas prices and groceries are not the only costs pressing Americans today. For seniors, the cost of prescription drugs can become a monthly burden for which many are unprepared.

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It is no secret that prescription drug costs can be expensive. To help combat these costs, you have options:

  • First, if you are eligible for Medicare, prescription drug coverage through Medicare Part D is an essential part of your insurance portfolio.
  • Next, utilizing discount programs like GoodRx and pharmacies like Cost Plus Drugs are great options to help you cut costs.
  • Finally, changing to generic prescriptions, when possible, can help you save hundreds of dollars each year on your out-of-pocket drug costs.

For many seniors, high drug costs can mean a choice between a relaxing retirement or receiving life-saving medications. To put this in perspective, in 2021, American seniors spent almost double in out-of-pocket drug costs compared to the rest of the world. 

Below, we review how you, as seniors, can reduce your prescription drug costs with the help of Medicare Part D coverage, prescription drug discount programs, and by switching to generic prescriptions.

How Medicare Part D Can Help Save on Prescription Drug Costs

Medicare Part D plans cover a predetermined portion of your prescription drug costs and leave you responsible for paying the remaining costs out-of-pocket until you meet your plans maximum out-of-pocket limit. When combined, your out-of-pocket expenses can rapidly increase due to the number of medications you require each month.

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Private insurance companies offer Medicare Part D plans, abiding by Medicare’s regulations. However, each insurance company can create its own drug formularies and set copayment and premium prices. Thus, the drugs you take specifically influence the Medicare Part D plan that is best for you.

For example, suppose John is prescribed Eliquis. Through one carrier, his yearly drug cost and premium could be $493.60. Yet, with another Medicare Part D plan through a different carrier, he may pay up to $3,926.98. To avoid a costly mistake, John should speak with a licensed agent who understands which plan is best for him based on his prescriptions. This example is a sample scenario, using two carriers in the same ZIP Code.

How Much Do Drugs Cost With Medicare Part D?

Medicare Part D carriers can set drug costs based on the plan’s formulary, which is the list of prescription drugs the plan covers. Each year, drug plan formularies change. Thus, your out-of-pocket costs may vary year over year.

When enrolled in a Medicare Part D plan, there are many advantages when compared to not having prescription drug coverage at all. Advantages to Medicare Part D plans include:

  • Maximum out-of-pocket limit
  • Preferred pharmacies with lower costs
  • Mail order pharmacy availability
  • Set drug costs

It is always recommended to enroll in a Medicare Part D plan as soon as you become eligible to avoid paying the Medicare Part D late enrollment penalty. This penalty accumulates each month you go without drug coverage and is permanent, meaning you must pay the penalty as long as you are enrolled in Part D.

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Medicare Part D Limitations

Depending on your prescribed medications, it is not uncommon to fall into the Medicare Part D coverage gap (donut hole) or meet your policy’s out-of-pocket maximum early in the year.

Medicare Donut Hole

When you reach the Medicare Part D Donut hole you will find that you owe a certain percent of the retail cost of your drug, regardless of how high that cost may be. When you find yourself in the donut hole, this is when your out-of-pocket drug costs reach an all-time high.

With this in mind, discount programs, generic drugs, and low-cost pharmacies can help keep you from having to pay higher costs down the road.

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How Discount Programs Can Help Save on Prescription Drug Costs

Discount drug programs like GoodRx and Cost Plus Drugs pharmacy help take the weight off consumers shoulders when it comes to prescription drug costs. These programs help to provide the exact same medications you already take at a fraction of the cost.

GoodRx works as a coupon program, allowing you to go to any pharmacy with a specific coupon. This allows you to lower your drug costs without utilizing your Medicare Part D benefits. Often, GoodRx coupons can save you money when compared to Medicare Part D prices.

Cost Plus Drugs is an online pharmacy that will fill your prescriptions at the manufactures cost with a 15% markup and additional cost for shipping. When compared to Medicare Part D drug costs and often GoodRx coupons, Cost Plus Drugs is typically the lowest cost when it comes to filling your prescriptions. However, you need to be sure they carry your medication before relying on the pharmacy.

Comparing Medicare Part D and Prescription Discount Programs

Whether you use Medicare Part D or a discount prescription program, the goal is to obtain the lowest cost medication through the most convenient route. For some, an online pharmacy is ideal. For others who prefer the traditional route, a drug coupon or in-person pharmacy experience may be the right fit.

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The chart below compares the prices of common Medicare Part D drugs with a popular discount pharmacy, Cost Plus Drugs, and the well-known drug discount service, GoodRx.

Prescription Drug Monthly Cost Comparison
Drug Name: Medicare Part D Cost Plus Drugs Pharmacy GoodRx
Amlodipine 2.5mg $10.70 $8.60 $14.13
Clopidogrel 75mg $10.70 $10.70 $14.15
Imatinib 100mg $189.18 $19.40 $117.37
Letrozole 2.5mg $16.00 $10.70 $13.20
Mesalamine 100mg $506.49 $37.40 $86.28

*Cost Plus Drugs Cost in the table includes $5 shipping fee

**Medicare Part D plan cost in the table includes a monthly premium for the lowest cost plan

***GoodRx cost in the table includes a $9.99 monthly GoodRx Gold membership fee

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It is essential to know that if you plan to use a GoodRx discount, you cannot use your Medicare Part D plan in conjunction. Thus, the money you spend out-of-pocket does not count towards your maximum out-of-pocket. GoodRx can only be used as a stand-alone discount.

Additionally, Cost Plus Drugs pharmacy does not utilize your insurance coverage at any time. So, you can utilize these programs even if you do not enroll in a Medicare Part D plan. Again, these costs will not count towards your Medicare Part D plans maximum out-of-pocket limit.

Limitations of Prescription Drug Discount Programs

Despite the low drug prices, discount programs and low-cost pharmacies are not always best to rely on.

Like any coupon, GoodRx discounts are not guaranteed. This means that even though your drug is covered at a low cost one month, it may not be available for that price the next month. Additionally, GoodRx may only cover brand name drugs. Thus, there could be a cheaper option through generic medications.

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As for low-cost pharmacies, the prescription drug you require might not be available through the pharmacy, so it is important to continue Medicare Part D coverage for these instances. Cost Plus Drugs, for example, has an extensive drug catalog. However, it does not cover all the medications available in the U.S.

If you take a less common medication, you may have a more difficult time finding coverage outside of Medicare Part D due to the low number of people taking the drug.

Switching to Generic Prescriptions Can Help Save on Prescription Drug Costs

Speaking to your physician about switching to generic medication is another way that many seniors are able to save money each month on prescription drugs.

Generic medications are the same as brand-name medications without the large manufacturer name behind them. All generic drugs are FDA-approved and provide the same care, risks, and results as their brand-name counterpart at a fraction of the cost.

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Generic medications typically use the same active ingredients and show the same results without the brand name and pricing. If a generic drug is right for you, this easy switch could be a massive benefit to your monthly budget.

Generic drugs can cost nearly 80% less on average than its brand-name counterpart drug. If widely utilized, generic drugs can save the U.S. healthcare system billions of dollars each year. The chart below compares brand name medication costs on a typical Medicare Part D plan to generic costs.

Generic vs Brand Name Drug Comparison
Generic Drug Monthly Copayment Cost  Brand-Name Drug Monthly Copayment Cost 
Atorvastatin $1.00 Lipitor $197.67
Omeprazole $1.00 Prilosec $417.65
Rosuvastatin $1.00 Crestor $191.50
Montelukast $1.00 Singular $287.79

As you can see, generic drugs typically have a very low copayment when compared to their brand-name counterpart drug. For many seniors, using generic drugs is a great way to save money each month while still receiving the same treatment recommended by their physician.

 Can You Reduce Your Medicare Drug Costs?

The easiest way to reduce your Medicare drug costs is to be on the right Medicare Part D plan for your prescribed drugs, utilize discount programs, and seek generic prescriptions when possible. By following these easy steps, you could potentially save yourself thousands of dollars each year on drug costs.

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While each option may not be best for each situation you may encounter, it is good to know that low-cost drug options are available to you.

By working with a licensed Medicare agent who is an expert in Medicare Part D plans, you can potentially cut your out-of-pocket costs in half simply by reviewing your Medicare drug costs annually.

In addition to thorough plan investigation, discount programs, generic medications, and low-cost pharmacies, many Americans hope to find drug relief through legislation such as the recently passed Inflation Reduction Act of 2022. This Act cap to Medicare Part D drug costs and helps alleviate the financial burden of prescription drugs for millions of Americans.

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