Prescription drug costs can be a major concern for Medicare beneficiaries, especially when certain medications aren’t covered or come with high copays. That’s where prescription discount cards come in—but can you use them with Medicare? Let’s take a closer look.
What are prescription discount cards?
Prescription discount cards are free or low-cost programs that offer reduced prices on medications at participating pharmacies. These cards work by negotiating lower prices with pharmacies, allowing users to pay a discounted cost for their prescriptions.
Can Medicare beneficiaries use them?
Yes, but not in combination with Medicare Part D plans. You can use a discount card instead of your Medicare coverage, but not alongside it in the same transaction.
Here’s how it works:
- If your Part D plan doesn’t cover a medication, or the copay is higher than the discount card price, you can opt to use the discount card.
- You must ask the pharmacist to process the prescription as a cash transaction, bypassing Medicare entirely.
Important note: These purchases do not count towards your Medicare deductible or out-of-pocket maximum.
When might a discount card be better?
- Your medication isn’t on your plan’s formulary.
- You haven’t met your deductible yet
- The discount card offers a lower price than your Medicare prescription drug copay.
What to watch out for:
- No double-dipping: You can’t use both Medicare and a discount card for the same prescription.
- No coverage tracking: Purchases made with discount cards don’t count toward your Medicare spending limits.
- Anti-Kickback Statute: Federal law prohibits combining manufacturer coupons with Medicare benefits.
Tips for smart savings:
- Talk to your pharmacist about which option saves you more.
- Review your Part D plan annually to ensure it meets your medication needs.
Prescription discount cards can be a valuable tool for Medicare beneficiaries, especially when used strategically. While they’re not a replacement for comprehensive drug coverage, they can help bridge gaps and reduce costs when Medicare falls short. For more information or to speak with a local insurance expert, call URL Insurance Group at 717-323-2000.
