If you are enrolled in Part D and having trouble affording your prescriptions or finding plans that will cover your drugs, there are several ways you may be able to fill the gaps in your coverage:
- Apply for Extra Help. This federal program helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage.
- Check for State Pharmaceutical Assistance Programs (SPAPs) in your state. These programs help residents pay for prescription drugs. Each program works differently, and not all states have SPAPs.
- Keep your retiree drug coverage. Talk to you or your spouse’s former employer to find out if your retiree drug coverage will fill gaps in Medicare’s prescription drug benefit.
- Buy an enhanced Part D plan. Enhanced plans charge higher monthly premiums than basic plans but typically offer a wider range of benefits. For instance, these plans may not have a deductible, may provide extra coverage during the donut hole, and may have a broader formulary. Some of these plans may also cover excluded drugs. Keep in mind that benefits vary by plan.
- Join a Medicare Advantage Plan that offers drug coverage with lower out-of-pocket costs. Medicare HMOs, PPOs, and other private health plans may offer drug coverage that lowers your up-front costs (such as the deductible). However, you will need to look at more than just the plan’s drug coverage: Also make sure the plan covers your preferred doctors and hospitals at a cost you can afford.
Keep in mind that after reaching catastrophic coverage, costs for your covered drugs will drop significantly.