10 Ways Older Adults Cut Medication Costs

The most common ways older adults pay less for prescriptions

Older adults on fixed incomes have several concrete ways to lower what they spend on medications each month. Some involve programs tied to your age or income; others are negotiating tactics you can use with your pharmacy or doctor right now. The ten methods below are the ones that actually work for people managing chronic conditions on Medicare or limited budgets.

Not every method works for every medication or every person. Some require paperwork; some require a phone call. The goal here is to show you what's possible so you can figure out which ones fit your situation.

Key Takeaways

• Medicare Part D plans vary widely in what they cover and what you pay, so comparing plans during open enrollment can save hundreds of dollars per year on the same medications.
• Manufacturer coupons and patient assistance programs exist for brand-name drugs and can reduce your out-of-pocket cost to zero, but you have to find them and ask your doctor or pharmacist for help.
• Generic versions of medications cost 80 to 90 percent less than brand-name drugs and work the same way for most conditions, though your doctor has to write the prescription to allow a generic substitute.
• Pharmacy discount programs like GoodRx and SingleCare let you compare prices across pharmacies in your area and sometimes cost less than your insurance copay.
• Talking to your doctor about lower-cost alternatives — different drugs in the same class, or older drugs that work just as well — can cut your medication bill without changing your treatment.

Compare your Medicare Part D plan during open enrollment

If you have Medicare, your Part D prescription drug plan determines what you pay for almost every medication. The plans available to you change every year, and the drugs they cover — and the prices they charge — vary significantly. Spending an hour comparing plans in October or November can save you $500 to $1,500 per year.

You do not need to switch plans if your current one still works for you. But if you take the same medications every month, enter those drug names into the Medicare Plan Finder tool on Medicare.gov. The tool shows you what each plan in your area charges for your specific medications, including your monthly premium and your out-of-pocket costs. Write down the total annual cost for the top three plans, then decide whether switching is worth the effort of changing pharmacies or dealing with prior authorization.

Open enrollment runs from October 15 to December 7 each year. Changes take effect January 1. If you miss the window, you cannot switch plans until the next year unless you have a may have access to life event — moving to a new state, losing other insurance, or becoming newly may be able to access for Medicaid.

Ask your doctor to prescribe generic medications

Generic drugs contain the same active ingredient as brand-name drugs and work the same way in your body. The FDA requires them to meet the same safety and quality standards. They cost 80 to 90 percent less because the manufacturer did not pay for the research and marketing that went into the original drug.

Your doctor can write a prescription that allows a generic substitute, or your pharmacist can ask your doctor for permission to fill a generic version instead. If your doctor prescribes a brand-name drug, ask why — sometimes there is a medical reason, but often there is not. If there is no medical reason, ask if a generic version exists and whether you can use it instead.

Some insurance plans charge higher copays for brand-name drugs than for generics, which gives you another reason to choose the generic version. Check your plan documents or call your insurance company to see what you would pay for each option.

Look for manufacturer coupons and patient assistance programs

Drug manufacturers offer coupons and free or reduced-price programs for their brand-name medications. These programs exist because the manufacturer wants you to use their drug instead of a competitor's or a generic version. You will not find them advertised on the bottle or in your pharmacy — you have to search for them.

Start by visiting the manufacturer's website directly. Search "[drug name] coupon" or "[drug name] patient assistance program." You can also ask your doctor's office or your pharmacist — they often have printed coupons or know how to find them. Websites like NeedyMeds.org and PatientAdvocate.org maintain searchable databases of manufacturer programs.

These programs usually require you to fill the prescription at a pharmacy, then submit paperwork or a coupon code to get money back or to reduce your copay. Some programs cap how much you save per year or have income limits. Read the terms carefully before you count on the savings.

Use a pharmacy discount program to compare prices

Pharmacy discount programs like GoodRx, SingleCare, and RxSaver let you search the price of a medication across pharmacies in your area. You enter your drug name and dosage, and the tool shows you what each pharmacy charges. Sometimes the discount price is lower than what your insurance would charge you.

These programs work by negotiating discounts with pharmacies — they are not insurance. You pay out of pocket and do not use your insurance. This makes sense when your insurance copay is high or when you have not met your deductible yet. It does not make sense if your insurance copay is already low.

Download the app or visit the website, search your medication, and compare prices at pharmacies near you. You will get a coupon code or a digital card to show the pharmacist. The discount applies at the register. These programs are free to use and do not affect your insurance coverage.

Talk to your doctor about lower-cost alternatives

Many conditions can be treated with several different medications. Your doctor may have prescribed the one that works best for you, but if cost is a problem, ask whether an older drug or a different drug in the same class might work just as well and cost less.

For example, some blood pressure medications cost much less than others but work equally well for many patients. Some cholesterol drugs have generic versions that cost a fraction of newer alternatives. Some pain relievers or anxiety medications have older options that are just as effective and far cheaper.

Bring a list of your medications and what you currently pay for them. Tell your doctor that cost is a barrier for you. Ask which of your medications might have a lower-cost alternative. Your doctor may need to adjust your dosage or monitor you more closely with a different drug, but the conversation often leads to real savings without sacrificing your health.

Check whether you may have access to for state pharmaceutical assistance programs

Most states run pharmaceutical assistance programs for older adults and people with disabilities who have limited income. These programs help pay for medications when Medicare, Medicaid, or private insurance does not cover the full cost. Income limits and covered drugs vary by state.

To find your state's program, search "[your state name] pharmaceutical assistance program" or call your State Health Insurance Assistance Program (SHIP). SHIP is a free counseling service funded by Medicare, and the counselor can tell you what programs exist in your state and help you understand whether you may have access to. Find your local SHIP office at shiptalk.org or by calling 1-877-839-2675.

These programs typically require you to apply with proof of income and a list of your medications. Processing takes a few weeks. Once you are enrolled, you submit your prescriptions and the program pays the pharmacy directly or reimburses you.

Ask your pharmacy about bulk discounts or price matching

Some pharmacies offer discounts when you fill multiple prescriptions at once or when you fill a 90-day supply instead of a 30-day supply. Others will match a lower price you found at a competitor. These discounts are not automatic — you have to ask.

Call your pharmacy and ask whether they offer a discount for filling several prescriptions together, or whether they would lower the price if you filled a three-month supply instead of one month. Ask whether they price-match if you found a lower price elsewhere. Some pharmacies say yes; some say no. It costs nothing to ask.

If your pharmacy will not negotiate, consider switching to one that will. Pharmacies compete for business, and some are more willing to work with customers on price than others. Call three or four pharmacies in your area and compare their prices on your most expensive medications.

Look into Medicaid if your income qualifies

Medicaid is a joint federal and state program that covers medical care, including prescriptions, for people with low income. Income limits vary by state, but many older adults with limited savings and modest monthly income may have access to. Medicaid covers medications that Medicare does not, and your copays are usually much lower.

You do not have to be on Medicare to may have access to for Medicaid, though many older adults have both. If you think you might may have access to, contact your state Medicaid office or call 211 to be referred to a local counselor who can help you understand the rules in your state. The application process takes a few weeks, and you may need to provide proof of income and assets.

Some states have expanded Medicaid to cover more people; others have not. Your may be able to access depends on where you live. A counselor can tell you whether you may have access to and what the application requires.

Use mail-order or online pharmacies to reduce costs

Mail-order pharmacies and online pharmacies often charge less than local pharmacies because they have lower overhead. If you take medications regularly and do not need them immediately, ordering a 90-day supply by mail can cost significantly less per dose than filling a 30-day prescription at a local pharmacy.

Many insurance plans encourage mail-order by charging lower copays for a 90-day supply ordered through their preferred mail-order pharmacy. Check your insurance documents or call your plan to see whether mail-order is an option and what you would pay. Make sure the pharmacy is licensed and accredited — look for the Verified Internet Pharmacy Practice Sites (VIPPS) seal on the website.

Mail-order takes longer, so plan ahead. Order when you have about two weeks of medication left so the new supply arrives before you run out. If you need a medication urgently, mail-order is not the right choice.

Ask about splitting pills or adjusting dosages

Some medications come in higher doses than you need. If your doctor prescribes a 20-milligram tablet but you only need 10 milligrams, ask whether you can fill a prescription for 20-milligram tablets and split them in half. The higher-dose tablet often costs the same or only slightly more than the lower dose, so splitting can cut your medication cost in half.

This only works for certain medications — tablets that are scored (have a line down the middle) can be split safely, but capsules and some other forms cannot. Ask your doctor or pharmacist whether your medication can be split. If it can, ask your doctor to write the prescription for the higher dose so you can split the tablets yourself.

Sometimes your doctor can also lower your dose if you are taking more than you need. If you have been on the same dose for years and your condition has improved, ask whether a lower dose would work just as well. Your doctor may say no, but the question is worth asking.

Frequently Asked Questions

Can I use a discount program like GoodRx if I have Medicare?

Yes. You can choose to use a discount program instead of your Medicare insurance for a specific prescription. This makes sense when the discount price is lower than your copay. You pay out of pocket, and the discount does not count toward your deductible or out-of-pocket maximum. Keep track of what you spend so you know when you have reached your deductible.

What if my doctor says there is no lower-cost alternative to my medication?

Ask your doctor to write a note explaining why the brand-name drug or higher-cost medication is medically necessary. Some insurance plans will cover a more expensive drug if your doctor documents that you have tried the cheaper option and it did not work for you. This is called a prior authorization exception, and it takes a few extra weeks but can result in coverage.

Do manufacturer assistance programs affect my Medicare benefits?

Manufacturer coupons and assistance programs do not count as insurance coverage, so they do not affect your Medicare may be able to access or your other benefits. Using them does not change your deductible or out-of-pocket maximum. However, some programs have income limits, so check the terms before you enroll.

How do I know if a mail-order pharmacy is safe?

Look for the VIPPS seal on the website, which means the pharmacy is licensed and inspected by the National Association of Boards of Pharmacy. You can also check whether the pharmacy is licensed in your state by contacting your state pharmacy board. Never order from a pharmacy that does not require a valid prescription.

What if I cannot afford my medications even after trying these methods?

Contact your doctor and tell them cost is a barrier. Ask about free samples, which manufacturers provide to doctors for patients who cannot pay. Call your local Area Agency on Aging or 211 to find out whether your community has a medication assistance program or a free clinic. Some nonprofits also help older adults pay for medications.