Prescription costs hit seniors hard, but several programs can dramatically lower them. Here is the help available and how to get it.
What programs help seniors pay for prescriptions?
The biggest help is Part D Extra Help, also called the Low-Income Subsidy, a federal program that lowers prescription drug plan premiums, deductibles, and copays for those who qualify. Importantly, enrolling in any Medicare Savings Program automatically qualifies you for Extra Help. Beyond that, some states run State Pharmaceutical Assistance Programs (SPAPs) that supplement Part D. Drug manufacturers offer patient assistance programs for specific medications, often free for low-income patients. Nonprofit foundations and pharmacy discount cards can help fill gaps. Together these options can cut a senior's drug spending substantially.
How Extra Help works and who qualifies
Extra Help is administered by the Social Security Administration and has income and resource limits set yearly, generally higher than those for Medicare Savings Programs, so more seniors qualify than expect to. Those who qualify pay reduced or no premiums and deductibles and lower fixed copays for covered drugs. You can apply through Social Security directly, or qualify automatically by enrolling in a Medicare Savings Program or Medicaid. Because the two programs are linked, it often makes sense to apply for both at once. Even seniors with modest savings frequently qualify thanks to resource exclusions.
Get a free prescription-savings screening
Sorting through Extra Help, state programs, and manufacturer assistance is easier with guidance. Call 1-800-MEDIGAP (1-800-633-4427) and a licensed specialist will screen you for Extra Help and Medicare Savings Programs, explain how they lower your drug costs, and help you apply. They can also point you to your state's pharmaceutical assistance program if one exists. There is no cost to get screened, and qualifying could save you hundreds or thousands of dollars a year on medications.