Medication Cost Reduction Tips

Medicare Part D

(click topic below to view details)

Check the Formulary

There may be a different medication that will treat your condition that is in a lower tier which may cost you less every month. Show the formulary to your doctor. Your doctor can help find the cheapest medication that is right for you.

Tier Exception Request

Senior Preferred has five drug tiers. If your doctor has prescribed a drug in a more expensive tier, you might be able to pay a lower tier cost if you can show that –

  • The lower-tiered drug options would not work as well as the prescribed drug
  • And / or that using the lower tier would likely cause medical problems

Note: drugs in Tier 5 are not eligible for a Tier Exception

Your doctor would need to include that information and may send it to us by filling out a Medicare Prescription Drug Coverage Determination Form.

Extra Help

If you have a limited income, Medicare has a program that can help: Extra Help

This program can help you pay for Medicare prescriptions. It may even help with premiums, deductibles and coinsurance.

For more information, do one of the following:

  • Visit www.socialsecurity.gov/prescriptionhelp (By clicking on this link, you will leave the Senior Preferred website)
  • Call (800) 772-1213 (TTY users call 1-800-325-0778)
  • Apply in person at the local Social Security office.

Be sure to fill out the Extra Help application to find out if you qualify for other subsidy programs.

 

Social Worker

Your doctor’s office or healthcare center may have a social worker available. Social workers can help you find ways to save money on medicine.

Manufacturer’s Pharmaceutical Assistance Programs

Some drug manufacturers will help you pay for medications they make. Often these programs are based on your income. If you qualify, the manufacturer will mail the medications to you or your doctor’s office.

State Pharmaceutical Assistance Programs (SPAPs)

Many states offer help paying drug plan premiums and / or other drug costs.

Rx Outreach

Rx Outreach is a fully licensed nonprofit mail order pharmacy. Rx Outreach provides prescription drugs to people who are uninsured or have limited drug coverage. It offers lower prices for more than 400 medications. Eligibility is based on income.

Medicare Part D and Medicare With No Drug Coverage

Aging and Disability Resource Center

The ADRC offers a benefits specialist and social workers who may help you answer medication coverage questions and concerns regarding ability to pay.

Consider Mail Order

Medications may cost less when filled for a three month supply through mail order. Refer to your Copayment Amount for details on your mail order benefit.

Drug Repository Program

Participating pharmacies can accept donated, unused, sealed medications. These can then be dispensed by a pharmacist to other patients for a minimal charge.

If you would like to donate medications, or find a pharmacy to obtain a donated medication for little or no cost to you, follow the link below to find a participating pharmacy:

Medicare With No Drug Coverage

(click topic below to view details)

Extra Help

If you need help paying for your medicine, check out the Extra Help program.

Extra Help is a Medicare program that helps people with low income.

This program can help you pay for Medicare prescriptions. It may even help with premiums, deductibles and coinsurance.

For more information:

  • Visit www.socialsecurityhelp.gov/prescriptionhelp (By clicking on this link, you will leave the Senior Preferred website)
  • Call (800) 772-1213 (TTY users call 1-800-325-0778)
  • Apply in person at the local Social Security office.

Be sure to fill out the Extra Help application to find out if you qualify for other subsidy programs.

Social Worker

Your doctor’s office or healthcare center may have a social worker available. Social workers can help find ways to save money on medicine.

Manufacturer’s Pharmaceutical Assistance Programs

Some drug manufacturers will hep you pay for medications they make. Usually these programs are based on your income. If you qualify, the manufacturer will mail the medications to you or your doctor’s office.

State Pharmaceutical Assistance Programs (SPAPs)

Many states offer help paying drug plan premiums and / or other drug costs.

Rx Outreach

Rx Outreach is a fully licensed nonprofit mail order pharmacy. Rx Outreach provides prescription drugs to people who are uninsured or have limited drug coverage. It offers lower prices for more than 400 medications. Eligibility is based on income.

Medicare With No Drug Coverage - Wisconsin Only

After you try Extra Help, Explore Wisconsin Senior Care

Must be a Wisconsin resident and 65 or older. Program is similar to Badger Care (same drug formulary). Visit Wisconsin Senior Care (By clicking on this link, you will leave the Senior Preferred website)

Additional Resources

  • Benefits checkup is a website run by the National Council on Aging. Visit: www.benefitscheckup.org (By clicking on this link, you will leave the Senior Preferred website). You can find out if you're eligible for help with:
    • Medication or health care costs
    • Income assistance
    • Food and nutrition
    • Housing and utilities
    • Employment and volunteering
    • Transportation and more
  • Partnership for Prescription Assistance offers an app that can tell you if you're eligible for medication assistance. Visit: www.pparx.org (By clicking on this link, you will leave the Senior Preferred website)
  • Compare Prices Among Pharmacies - Use our Pharmacy Benefit Online Tool in MyChart to compare what your medications would cost at different pharmacies.

This web page was updated on October 1, 2019.