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:

  1. Apply for Extra Help. This federal program helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage.
  2. 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.
  3. 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.
  4. 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.
  5. 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.