Managing Rising Drug Costs Under Medicare

Key Takeaways

• Medicare Part D won’t cover every dollar spent on prescriptions, but the $2,100 cap is a big step forward.
  
  
• There are programs and resources to help you save — from patient assistance programs and non-profits to state-based help and cost-saving pharmacies.
  
  
• Always check eligibility, since not every program works with Part D coverage.
  
  
• Planning ahead can help you lower your costs and avoid surprises at the pharmacy counter.

Prescription drug costs can feel overwhelming — even with Medicare Part D. But there’s good news: starting in 2026, out-of-pocket costs under Part D will be capped at $2,100 per year. Once you reach that limit, your plan will cover 100% of covered medications for the rest of the year.

Still, reaching that cap can be a challenge. Many folks are finding it hard to pay for expensive medicines, and coming up with the $590 deductible is difficult.  The good news is there are ways to plan ahead and resources to help you save. Here’s what you need to know.

How Medicare Part D Works

Most Part D plans come with a deductible. Typically:

• Tier 1 & Tier 2 drugs often skip the deductible and only require a copay or coinsurance.
  
  
• Tier 3, 4 & 5 drugs usually require you to pay the full price until you’ve met your deductible.
  
  

After that, you’ll pay copays or coinsurance until you reach the $2,100 cap — and then, for the rest of the year, your covered medications cost $0.

Can You Use Copay Assistance Cards with PART D Medicare?

Unfortunately, no. Federal anti-kickback laws prevent copay assistance cards from being used with Medicare. They may work with commercial insurance, but not with Part D plans.

Can You Use Pharmacy Discount Coupons?

Yes — in many cases! Programs like CleverRX and GoodRX can lower costs, especially for generic drugs. For brand-name medications, savings may vary.

Keep in mind: you’ll need to choose between using the coupon or your Part D plan — you can’t use both at the same time. If you use a drug discount card, those costs you pay will not be applied to your part D deductible and TROOP out of pocket costs.

5 Other Ways to Save on Prescription Drugs

Here are a few more options to explore:



1. Patient Assistance Programs (PAPs)
   Many drug manufacturers — including AbbVie (Humira), Eli Lilly (Taltz, Trulicity), Janssen (Xarelto), Novo Nordisk (Ozempic), and Pfizer (Ibrance) — offer programs to help with costs.
   
   

• Eligibility often depends on income.
  
  
• You can search for programs at:
  
  
• NeedyMeds.org
  
  
• MedicineAssistanceTool.org
  
  

  2. Non-Profit Assistance Programs

      Organizations like the PAN Foundation (covering 70+ conditions) and Co-Pay Relief help with high-cost        medications. Slots can fill up fast, but many have waitlists and email updates to notify you when funds          are available.

  3. Extra Help Programs 

If you qualify for Extra Help, you may receive assistance with premiums, deductibles, and copays.       Contact your local Social Security office @ 1 800-772-1213 to inquire or apply online (LINK)  https://www.ssa.gov/medicare/part-d-extra-help.

  4.  Canadian MedStore

This Florida-based company can provide cost-effective medications. You’ll need your prescription details, doctor’s contact information, personal info, and payment to place an order.

  5. The Medicare Prescription Payment Plan. 

A new program that started in 2025 with all part D sponsors that allow members to pay their drug costs over the course of the year.   Call your Part D Drug Plan directly to sign up for the program.

Let’s Plan Ahead Together
Working with our team means you won’t have to navigate these updates alone. We’ll help you:

• Understand what’s changing and how it affects you.
  
  
• Identify opportunities to save.
  
  
• Select a plan that keeps you confidently covered in the year ahead.

Let’s make sure you’re prepared —  reach out to us today either by phone, 530-303-3366

or head to our website at www.beuttelinsure.com/contact and feel confident knowing your Medicare coverage is ready for the changes ahead.