Prescription discount programs help control Medicare drug costs

Dear Toni: I had a great experience that helped me avoid the Medicare “doughnut hole” with an expensive generic prescription for Parkinson’s disease.

My Plan D preferred pharmacy informed me that the specific generic was not in my Part D plan’s formulary and would cost $460 per month. I went to another pharmacy and was told that the retail price was $199 per month.

A friend told me about GoodRx.com. After I entered my ZIP code, GoodRx gave me a printout of stores that sell the drug at a discounted price with no strings attached. I went to one on the list with the GoodRx coupon. The cost for a one-month drug supply was only $43.

How can the price of a generic drug range in price from $43 to $460?

Something is wrong with America’s prescription drug system. Tell your readers not to give up if they get an outrageous price for a drug. There are several websites like GoodRx providing a similar service. You just have to do your homework. — Sarah from Tulsa, Oklahoma

Dear Sarah: Thank you for this information. Discount programs such as GoodRx, SingleCare and ScriptRelief can be great resources to help control the cost of Medicare prescription drugs.

By not placing these expensive generic or brand-name drugs on your Part D plan, you can avoid the doughnut hole or not get into it as quickly.

I had an antibiotic and an allergy medication prescribed last week. Using my Medicare Part D plan, both generic prescriptions together were over $120.

I remembered Sarah’s email, and while sitting in the store’s parking lot, I looked online at GoodRx. The savings was more than $60. (Other pharmacies would have saved me more money, but the prescription had already been sent to that pharmacy.)

On its website, GoodRx claims that it is recommended by pharmacists and doctors. Next time, I will go to GoodRx or another prescription discount site and research which pharmacy has the lowest price before I get a new prescription.

Part D costs for 2024

Readers, Part D costs will be changing for 2024. Here is a summary:

■ Initial deductible: $545

■ Initial coverage limit: $5,030, at which point the 2024 doughnut hole begins.

■ Doughnut hole out-of-pocket costs: You will pay 25 percent of the brand-name drug cost, the drug company will pay 70 percent, and the chosen Part D plan will spend 5 percent until the total spent on your prescriptions is $8,000. Then the doughnut hole ends and catastrophic coverage begins.

■ New catastrophic coverage rule: Beginning Jan. 1, when a Medicare recipient enters catastrophic coverage, Medicare will pick up all prescription costs, whether brand name or generic, for those with a Part D plan.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.