STRATEGIES TO SAVE MONEY ON PRESCRIPTION DRUGS

Many Medicare recipients are benefiting from changes that make prescriptions more affordable. But you can still make other moves to keep your costs in check.

- BY KIMBERLY LANKFORD

PRESCRIPTION drug costs have risen significantly over the past several years. Among drugs that went up in price from January 2022 to January 2023, the average increase was 15.2%, and it was 11.5% the previous year, according to the most recent data available from the U.S. Department of Health and Human Services. A Commonwealth Fund study found that 14% of Medicare beneficiaries didn't fill a prescription or skipped a dose of their medication because of the cost. “The inability to afford the prescription you need could have long-term implications on your health outcomes,” says Gretchen Jacobson, vice president of Medicare for the Commonwealth Fund.

But the past few years have also brought changes that should make prescription drugs more affordable for many people with Medicare Part D or Medicare Advantage plans. The Inflation Reduction Act of 2022 limited co-payments for covered insulin to $35 per month, eliminated cost sharing for adult vaccines covered by Part D, expanded the Extra Help program (which assists with premiums and co-payments for low-income Medicare beneficiaries), and gave the government the go-ahead to start negotiating prices with drug companies. The dreaded “doughnut hole”—which originally required beneficiaries to pay 100% of their drug costs after costs reached a certain level—has disappeared. Instead, your out-of-pocket costs for covered drugs are capped at $2,000 per year, starting in 2025.

“It’s a lot easier to navigate and predict your Part D costs now,” says Caitlin Donovan, senior director of the Patient Advocate Foundation, a nonprofit that provides free case management and financial assistance to people who are diagnosed with serious medical conditions.

Drug plans have been adding restrictions to coverage that require you to jump through hoops before they’ll cover your medication.