How Medicare members can lower prescription drug costs

By BETHANY CISSELL NEW YORK DAILY NEWS | APR 01, 2021 AT 7:43 PM

With the cost of prescription drugs rising and many in the nation experiencing employment disruptions, a lot of people may still be struggling to afford essentials like their medications. Here are answers to a few common questions Medicare beneficiaries may have about drug price increases, as well as a few simple ways to help lower costs.

How much have drug prices increased for Medicare members?

Prescription drug prices are getting expensive. According to an analysis by the Kaiser Family Foundation, half of all Part D-covered drugs had list price increases that exceeded the rate of inflation between July 2018 and July 2019. Among the drugs with list price increases exceeding inflation between 2018 and 2019, the median list price increase was 6.4%, or 3.5 times the rate of inflation.

Additionally, list prices increased by 10% or more for 450 of all Part D-covered drugs between 2018 and 2019. At the same time, more than one-third of these drugs saw price increases above the rate of inflation, but below 10%. For 22 of the 25 drugs with the highest total Medicare Part D spending in 2019, prices increased faster than inflation between 2018 and 2019.

How can I lower the cost of my prescriptions?

Reaching out to a Medicare expert can help point you in the right direction. Thankfully, there are plans in place to help those experiencing stretched finances. Low Income Subsidy (LIS) or “Extra Help” is assistance that can lower prescription co-pays, cover all or part of the monthly premium for Medicare Part D, or help avoid the “donut hole” of coverage for medications by having a set prescription cost for brand name and generic drugs.

Medicare beneficiaries who apply for Extra Help with their Medicare prescription drug plan costs save, on average, about $5,000 per year. To qualify, you must be receiving Medicare, have limited resources and income, and be a resident in one of the 50 states or D.C.

There are also savings at the local level, such as through a State Pharmaceutical Assistance Program. The Medicare website has a tool to help determine if your state offers a relevant program and to view the eligibility requirements and application instructions.

Some pharmaceutical companies offer a Pharmaceutical Assistance Program based on the specific prescription you take and criteria established by the drug company, and eligible members can find significant savings by applying for these programs as well.

Bethany Cissell is an account manager at Allsup, a nationwide benefits firm based in Belleville, Ill., that provides guidance and education on alternative health care coverage options for employees and retirees. Bethany works for the Allsup Benefits Coordination service, a Medicare plan selection service available nationwide.

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