People With Medicare
How can I lower my costs in the coverage gap?
While in the coverage gap, Medicare provides discounts on certain drugs.
In 2013, you will pay 79% of the cost for generic drugs and 47.5% of the cost for brand name drugs that your plans covers while in the coverage gap (in 2014, 72% and 47.5% respectively). You do not need to do anything to get these discounts. Your pharmacy will give it to you automatically.
There are also several other things to help lower your drug costs while you are in the coverage gap - especially if you have a limited income:
- If you have a limited income and assets, apply for the Extra Help available through Medicare Part D. If you qualify, you will have no coverage gap. Visit our Extra Help section to learn more about the Extra Help and see if you might qualify.
- If your state has a State Pharmaceutical Assistance Program (SPAP), consider signing up for it. Visit our SPAP section for more information.
- Apply for help from a certified charity like a copay foundation, if there is one for any of your medicines. See a list of these charities.
- If you're taking brand name drugs, talk with your doctor about switching to generic drugs. Generic drugs usually cost less, and some plans may cover your generic drugs if you reach the coverage gap. Or ask your doctor about switching to a lower-cost brand name drug that treats your condition.
- Apply for help from a Patient Assistance Program that serves people in Medicare Part D plans. Visit our PAP section for more information. If you use a Patient Assistant Program, you must submit your out-of -pocket costs to Medicare yourself, or they will not count towards your total drug costs. Check with your Part D plan to see how you should submit your out-of-pocket costs.
- See if your doctor can give you free samples of any of the medicines you take.
- Contact your county public health department to see if they have a free medicine program.
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