More than 5 million Medicare beneficiaries struggle to pay their prescription drug costs, according to the U.S. Department of Health and Human Services. And rising healthcare expenses in 2024 aren't going to make this any easier.
Shopping around for a new Part D plan or Medicare Advantage plan with prescription drug coverage during the open enrollment period is one of the best ways to keep your costs affordable in 2024. But there are three other things you can try as well.
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1. See if you qualify for Extra Help
Extra Help is a Medicare program that helps low-income families get their prescription drugs at an affordable price. To qualify, your income and resources must be below certain levels, depending on where you live, whether you're still working, and the number of people in your household. Here's a look at the requirements for a single adult and a married couple with no dependents:
|
Yearly Income |
Resources |
|
|---|---|---|
|
Single person |
Less than $21,780 |
Less than $16,600 |
|
Married couple with no dependents |
Less than $29,580 |
Less than $33,240 |
Data source: Center for Medicare and Medicaid Services.
Here's a quick breakdown of which of your assets count toward your resources and which don't:
|
What Counts |
What Doesn't Count |
|---|---|
|
|
Data source: Center for Medicare and Medicaid Services.
You automatically qualify for Extra Help if you meet any of the following criteria:
- You have full Medicaid coverage.
- Your state helps you pay your Medicare Part B premiums through a Medicare Savings Program.
- You receive Supplemental Security Income (SSI) benefits.
Even if none of the above factors pertain to you, it's worth applying to see if you qualify. Those who are still working, those who live in Alaska or Hawaii, and those with dependents may be eligible with higher incomes.
You can apply at any point during the year, and if approved, your coverage will last through Dec. 31 of that year, even if your income changes. In 2023, there are two tiers of Extra Help: Partial and Full. Full Extra Help pays for your Part B premium and deductible while Partial Extra Help results in a reduced deductible and premium. Beginning in 2024, all those who qualify for Partial Extra Help will automatically receive Full Extra Help.
Both tiers cap how much you pay out of pocket for drugs. In 2024, you'll only pay a maximum of $4.50 per prescription for generic drugs and $11.20 per prescription for name-brand drugs. And if your total prescription drug costs, including what Extra Help pays on your behalf, exceed $8,000 during the year, you won't pay any more for your prescriptions.
If you're approved for Extra Help, the government will automatically enroll you in a Part D plan if you don't have one already. But you're free to change this if you prefer another option. Those thinking about enrolling can check out 2024 Part D plans on Medicare's website.
2. See if you qualify for a state pharmaceutical assistance program
Currently, 44 states as well as the District of Columbia and Puerto Rico offer pharmaceutical assistance programs to residents who need help paying for their prescription drug costs. Some states have more than one program. You can view all the options available in your state on Medicare's website.
Each program has its own set of eligibility criteria and services. Some may also require seniors to pay a small annual enrollment fee or visit specific pharmacies participating in the program in order to take advantage of its benefits. Be sure to review all the program terms before applying, and reach out to the appropriate state organization with any questions. You can find the contact information for each pharmaceutical assistance program on the Medicare website linked above.
3. Look into other pharmaceutical assistance programs
Pharmaceutical companies also offer assistance programs for some medications to seniors who are unable to afford the regular price. You can browse or search drugs with assistance programs on Medicare's website.
If there's a result, you'll be able to review the eligibility criteria for the program as well as the program's website and contact information so you can apply. As with the state programs, review everything carefully so you understand what you're signing up for before you proceed and reach out to the organization if you have any questions.
All of these things can help make your prescription drug costs more affordable. But you need a good Part D plan to serve as your foundation. So be sure to compare your options before the Medicare open enrollment period ends on Dec. 7, 2023. If you don't, you'll have to wait until next year in order to make changes to your health coverage.
