June 2023: How to Lower Your Prescription Drug Costs
Apply for Extra Help
- You may qualify if you have limited income and assets. Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. If you have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help. If you have Medicare but do not have Medicaid, SSI, or an MSP, see the chart below to learn if you qualify. If you think you may qualify, you can apply through the Social Security Administration (SSA). Visit www.ssa.gov or call 800-772-1213 to learn more.
Learn about any State Pharmaceutical Assistance Programs (SPAPs) in your state
- Call your local State Health Insurance Assistance Program (SHIP) to find out whether your state has an SPAP, if you are eligible, and how to apply. Go to shiphelp.org to contact them.
Talk to your doctor
- Ask your doctor if a generic drug could work for you. Generic drugs are often less expensive than brand-name drugs.
- Ask your doctor if they can provide you with samples of your medication. This is only a temporary solution.
- Ask your doctor for assistance with appealing. If your drug is not covered or is covered on a high cost-sharing tier, you may be able to appeal.
Learn about any Patient Assistance Programs (PAPs) that could help you
- Some drug manufacturers offer PAPs. Your doctor may have to apply for you, and eligibility varies based on the program.
Ask your pharmacist to waive your copay
- While they may not be able to do so routinely, your pharmacist may be able to waive copays on a case-by-case basis.
Look for charity programs that help pay drug costs
|More About The Extra Help Program|
|If your income is:||And your assets are:||You can get:||Your 2023 copays are:|
|Up to $1,843 per month for individuals
Up to $2,485 per month for couples
|Up to $16,660 for individuals
Up to $33,240 for couples
|Partial Extra Help||15% coinsurance or the plan copay (whichever is less)
After reaching catastrophic coverage, $4.15 per generic and $10.35 per brand-name (or 5% of the drug cost, whichever is greater)
|Up to $1,660 per month for individuals
Up to $2,239 per month for couples
|Up to $10,590 for individuals
Up to $16,630 for couples
|Full Extra Help||$4.15 generic copay
$10.35 brand-name copay
No copay after reaching catastrophic coverage