A common misconception is that when one gets on Medicare, many of their drug costs will be low and inexpensive. Unfortunately, this couldn’t be farther from the truth. You see, even though you may be on a Medicare Advantage plan that includes prescription drugs or have a stand-alone Part D plan, some prescription medication such as insulin can be very costly. This is a common issue across many of the different plan options out there and what we like to do is to go beyond the call of duty and assist our clients in any way possible, which often means finding outside assistance in some cases.
One such instance of a possible remedy entails getting assistance from a federal program called “Extra Help” or also called “Low-Income Subsidy”. This program if one qualifies, can help tremendously with drug plan premiums, deductibles, and drug costs and in 2018, would be no more than $3.35 for each generic medication and $8.35 for each brand-name covered drug. So that insulin that is costing you hundreds per month, just got cheaper if one qualifies. Sounds great huh? To qualify, one must reside in one of the 50 states or the District of Columbia, your resources must be limited to $14,400 for an individual or $28,150 for a married couple living together. Some examples of resources include bank accounts, stocks and bonds but do not include your home, car or even life insurance policies. Income wise, the limits are $18,090 for an individual or $24,360 for a married couple living together. Keep in mind, that even if the income is a little higher than this, you may still get some form of assistance, especially if you support other family members living with you.
An alternative is to reach out to the drug manufacturer for possible assistance, but keep in mind, usually those on Medicare can’t qualify or any other federal health plan such as the VA. However, we did some research and found that one instance of help in this realm is viable, from the Novo Nordisk Patient Assistance Program (PAP), which can help those who qualify with medications such as Tresiba, Levemir, and Novolog get these medications at no cost, for up to a year. One of the main qualifiers is that you have spent a total of at least $1,000 on prescriptions in the year and fall within the federal poverty level (FPL) at or below 300%.
Lastly, we recommend asking your physician who prescribes you the costly medication about generic drugs that garner the same results as brand name drugs, or ask for samples when you go in for visits. GoodRX is also a good option, which is an application which is free to use and provides instant coupons for many drugs we take. This is usually more helpful for generic drugs, but it is best to check all your medications and see how they come out with GoodRX. You simply show the pharmacist the coupon codes and off you go with the discounted rate. We often encourage our clients to utilize GoodRX, in combination with their prescription drug plans, to ensure they are getting a square deal on their drug costs.
Here at The Harrin Group in San Antonio, Texas, we look out for your best interests, not ours or the insurance companies. Every dollar saved is money you can spend on that vacation you’ve been waiting for or giving that special present for your loved ones, come birthday time.
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