Introduction To The Coverage Cap

Most Medicare drug plans (Part D) have a temporary limit on what they will cover for prescription drugs, or a “coverage gap.” The good news is that all Medicare drug plans provide coverage if you have an unexpected illness or injury that results in extremely high drug costs…read full article

Generic vs. Prescription Drugs

According to the Food and Drug Administration (FDA), a generic prescription drug is the same as a brand-name prescription drug in safety, strength, quality, the way it works, how it’s taken, how much should be taken, and the way it should be used…read full article

Consider switching to generic, over-the-counter (OTC), or other lower-cost drugs

Ask your doctor about generic, OTC, or less-expensive brand-name drugs that would work just as well as the ones you’re taking now. Switching to lower-cost drugs may be enough to help you avoid the coverage gap, and can save you hundreds or thousands of dollars a year.

Keep using your Medicare drug plan card

Keep using your Medicare drug plan card, even while in the coverage gap. Using your drug plan card ensures that you’ll get the drug plan’s discounted rates and that the money you spend counts toward your catastrophic coverage.

Explore National and Community-Based Charitable Programs

These organizations might offer assistance (such as the National Patient Advocate Foundation or the National Organization for Rare Disorders). These organizations may have programs that can help with your drug costs. Comprehensive information on Federal, state, and private assistance programs in your area is available on the Benefits Checkup Website.

Look at State Pharmaceutical Assistance Programs (SPAP)

There are 23 states and 1 territory offering some type of coverage to help people with Medicare with paying drug plan premiums and/or cost sharing.

Apply for Extra Help

If you have Medicare and have limited income and resources, you may qualify for extra help paying for your prescription drugs. Contact Social Security.