Using prescription manufacturers’ coupons and Medicare together, to pay for medications is illegal. But, you can use drug coupons instead of using Part D. It’s smart to use the coupon when Part D would cost more than using a coupon or discount card.
Why Can’t Medicare Patients Use Prescription Coupons?
Using drug coupons for medications is perfectly legal. But, combining them with Part D coverage isn’t allowable. When using drug coupons, you must pay without using your Part D plan.
Determining when you’ll save more money is the tricky part. Pharmacies can leave your options unclear, making it hard to decide which option is more cost-friendly.
Partially due to the contracts that pharmacies and pharmaceutical companies have with each other.
Pharmacy benefit managers act as “middlemen” negotiating contracts between the two parties. Pharmacy benefit managers establish drug formularies, set up discounts and rebates for manufacturers, and process the pharmacy’s claims for prescription medications.
Best Prescription Discount Cards
The eight most popular discount programs are:
- GoodRx
- Script Relief
- SingleCare
- ScriptSave WellRx
- Blink Health
- The U.S. Pharmacy Card
- Medicare Plus Card
What is The Anti-Kickback Statute?
Social Security Amendments of 1972 made it illegal for pharmaceutical companies to give discounts for any medications bought through Medicare. The 1972 Amendments also include the Anti-Kickback Statute. Making it illegal for anyone, to offer drug coupons and rebates to customers for items or services that a federal healthcare program pays.
When a pharmaceutical company suggests you choose a more expensive drug option, Medicare spends more money than if you chose the lower-cost generic medication. Although the manufacturer offers a discount, coupons are generally for their newest and more expensive medicines.
Also, these drug coupons usually have a small lifespan plus an annual maximum cost. This means you and Medicare would be responsible to pay the remaining amount for the rest of the year.
The Anti-Kickback Status prevents individuals from abusing the system. In turn, Medicare reduces cost spending.
Can Medicare Patients Use a Discount Card with Part D?
Now, you can use a discount card instead of Part D! For more information on if you qualify for a coupon, you can always contact your pharmacy or the manufacturer.
Can Medicare Patients Use GoodRx Prescription Coupons?
GoodRx is a free program that gathers discounts and the most current drug costs. If you have Part D, can you use GoodRx? Yes, you can use GoodRx when you have a Part D plan.
In some cases, the prices may be lower than what you’ll pay through insurance. So just how does GoodRx provide you with these exceptional prices? GoodRx gets its pricing from several different avenues. The most popular channel is the price negotiations.
GoodRx negotiates with pharmacy benefit managers. Which provides customers with discounted drug costs. Pharmacy benefit managers are third-party administrators of drug programs for drug plans.
Can I Use a Drug Discount Card with Medicare Advantage?
Medicare Advantage plans prove to be helpful. But even if you don’t have drug coverage through your Advantage plan, you can still save money on your medications.
Many Medicare Advantage policies include Part D. Just like with Medicare, you can use either your built-in coverage or a discount drug card. You can use your discount card to save on your drug costs if it saves you more money than your Medicare Advantage plan.
FAQs
How to Use Prescription Coupons When You Have Medicare
We understand, especially on a fixed income, that you’re looking for ways to save money. Drug discount coupons and cards can seem like an appealing option. Yet, it’s essential to be informed about the facts.
That’s where we can help. We’ve assisted countless individuals in signing up for the right Part D prescription drug plans, and we can do the same for you. Just call the number above or fill out an online rate form. You’ll be able to compare plans in your area, and we’ll help you make the best choice.
Thanks for a great article. Can you specify exactly which CMS provisions allow a Medicare recipient to choose whether to utilize a manufacturer’s coupon or their Medicare coverage?
Hi Sharon! You can tell the pharmacy to use your coupon instead of your Part D plan at any time.