Medicare Part D plan coverage is voluntary and you are not required to use your Medicare Part D plan when purchasing medications.
Instead, you are allowed to use a drug discount card or you can ask your local pharmacy about their everyday low prices - but remember, you cannot use
your Medicare Part D plan together with a drug discount card.
Also, you may find that your regular pharmacy may have your Medicare Part D information on file and automatically process your prescriptions fill or refill under your Part D coverage, so you may need to ask that your prescriptions are processed using a drug discount card or a discount coupon or the pharmacy's everyday low pricing.
Example: Using a Drug Discount Card when you have very few, low-costing generics.
If you have very low (or no) prescription costs such as when the retail cost of your prescriptions is under $33 per month and your Medicare Part D plan has a $435 Initial Deductible
(and low-cost Tier 1 and Tier 2 drugs are not excluded
from the deductible), you will never leave your Medicare Part D plan's Initial Deductible and be responsible for 100% of your medication costs.
Question: Is a Drug Discount Card always cheaper than my Part D coverage?
It is always worth checking Drug Discount Card prices, but be sure to compare theses discount prices to your Medicare plan's coverage cost or negotiated retail drug price and you may find your Medicare drug plan's price are lower than the drug prices offered with a drug discount card.
This means you will often pay less for a drug when using your Medicare Part D plan coverage - even if you are paying 100% of the cost in the Initial Deductible. You can view our Q1Rx.com Drug Finder
for an overview of your Medicare plan's average retail drug pricing - and see an estimated price
using a drug discount card at the top of the chart.
As an example:
Using the generic drug 20 mg Duloxetine HCL, you can see in our Q1Rx.com Drug Finder
example below that some Medicare Part D plan prices are less than the estimated drug discount card and some average Medicare Part D plan prices are far greater than the price using a drug discount card (- and don't forget: retail drug prices can change throughout the year).
So, as noted above, even if you are in your Initial Deductible and responsible for 100% of the drug cost, your full drug cost with your Part D plan (for example, $18.26) is less than the estimated drug discount card price when using a Discount Card ($25.20). And naturally, if you were out of your Initial Deduction using this same example, you would only pay 25% of the $18.26 for a prescription fill.
Question: Can I still get credit for my drug purchases even when not using my Part D drug plan?
After making a purchase, you can ask your Medicare Part D plan about submitting the receipts toward your annual out-of-pocket (TrOOP) spending records. In that way, if your medication needs change, and you need to purchase more expensive medications, your previous formulary prescription drug purchases will count toward exiting the Initial Deductible.
Please note, in most cases, your Medicare Part D plan will not reimburse
you for drug purchases made outside of the Medicare Part D plan, but you can ask that the value (what you spent) for the formulary drugs is recorded by your plan. (There are exceptional cases when your Part D plan may reimburse you for non-Part D drug purchases such as when you cannot find a network pharmacy to fill a prescription.)
For more information about submitting your receipts for formulary drug purchased without your Medicare Part D plan, please contact your Medicare Part D plan's Member Services using the toll-free telephone number found on your Member ID card.