Confirming the price of a medication when on Medicare can be incredibly frustrating. We help our clients with this every day, but only based on the medications we know you take at this very moment.
What if you’re prescribed a new medication and need to check the price quickly? How can you get general pricing information to make an informed decision?
Here are 4 options:
Contact Us
If you’re a client of ours, you can contact us about drug pricing! We have access to tools to look-up medication costs in all Medicare Part D plans and Medicare Advantage plans. Then we’ll explain how your plan’s drug coverage works and what to expect month-to-month when you fill medications. Our analysis shows the cost of each of your medications on a monthly basis. The Medicare.gov website doesn’t show you this kind of detail, rather it simply sums up the total for all medications combined in each month...so you can’t always see how that total was calculated.
GoodRx.com
GoodRx is a website (and smartphone app) that offers cash discount deals on many prescriptions...sometimes at a lower price than what you can get through your existing insurance. If you can find a lower price with GoodRx, go for it. Just use GoodRx on a separate transaction.
This means you CAN use GoodRx coupons when you have other insurance. You just can’t use GoodRx AND your existing insurance at the same time on the same medication. Your existing insurance will NOT coordinate with GoodRx (or other cash discount websites).
If you’re wondering whether a medication is covered under Part D plans, in general, the website has a Medicare tab that gives you a decent indication. It will say NO, if no plans cover the medication. And then for medications covered by Part D plans, it will say YES with a percentage of plans that include the medication on their formulary list of drugs. However, it won’t tell you specifically which plans cover it. We can confirm that for you, as well as the insurance carrier, or through Medicare.gov.
NOTE: Some GoodRx coupons have a stipulation that it specifically will NOT work when you have access to other insurance, like Medicare or Medicaid. So be sure to check the coupon for any notations like this before trying to use it. Check the frequently asked questions section of every coupon to make sure it’s okay to use when on Medicare.
And GoodRx has a great blog of their own on using their coupons while on Medicare. Check it out here: Yes, You Can Use GoodRx If You Have Medicare
Another popular coupon site is Singlecare.com
Insurance Carrier Website or Customer Service Phone Line
Many insurance carriers include a Part D medication look-up tool on their websites. So you can get pricing pretty quickly online.
And you can of course call the insurance carrier’s customer service phone line to verify pricing. This won’t be the quickest route, though, as you’ll likely have to wait to get a live person for assistance.
Medicare.gov
And then there’s Medicare’s website. Anyone can use the Plan Compare feature online at http://www.medicare.gov/plan-compare. After entering in some basic information, such as your zip code, the type of plan you’re looking for, and how you wish to receive medications (via pharmacy or mail order), you can enter your medication information to view pricing in your existing plan or in all other plans available to you. At first glance, it can be difficult to understand how they lay out the data, but it’s a great resource when looking up pricing on your own.
And remember, Medicare Part D drug pricing depends on which phase of Part D you’re in when you make the purchase. There are four phases of Part D, so be sure to read our blog, How Medicare Part D Works, for more detail.
Reference Links
www.goodrx.com
Yes, You Can Use GoodRx If You Have Medicare
www.medicare.gov/plan-compare
How Medicare Part D Works
Neither Medicare Mindset LLC nor its agents are connected with the Federal Medicare program.
