Medicare Part D prescription drug plans may work together with certain drug assistance programs, but in general, a person eligible for Medicare is not able to use both their Medicare Part D plan and a drug discount program at the same time for additional or cumulative benefits.
Non-Medicare Drug Discount CardDepending on the terms of the program, you may be able to use a discount card or other pharmacy discount during your
deductible period or while in your Medicare plan's
Coverage Gap. In some cases, a network pharmacy may accept a discount card or offer another cash price discount so that you can pay less for a prescription than your plan's negotiated price. This is considered a one-time "lower cash" or special price. In the past, if you are able to obtain a cash discount to pay an amount that's lower than your plan's price, you would send your receipt to your Medicare drug plan. However, with changes to the
Lower Cost Pricing policy, you may find that your Medicare plan will no longer honor such requests for reimbursements.
Patient Assistance Program (PAP)Patient Assistance Programs (PAPs) can provide assistance to Part D enrollees and interface with Part D
plans by operating "outside the Part D benefit" to ensure separateness
of Part D benefits and PAP assistance. The PAP's assistance on behalf of
the PAP enrollee does NOT count towards a Part D beneficiary's
true-out-of-pocket cost (
TrOOP). The calculation of TrOOP is important
for determining whether an individual has reached the threshold for
catastrophic coverage under the Part D benefit.
Supplemental Health Insurance (not Medigap)You should check with your Supplemental Health Insurance Plan to see how it will compare to Medicare drug coverage - in most cases, these plans do not offer creditable prescription drug coverage (that is, coverage as good as provided by a standard Medicare Part D plan).
Older Example (One-time "lower cash" or special price)You
are in the coverage gap, so you have to pay for the total amount of
your prescription. The plan usually charges $100 (its negotiated price)
for the drug you need. By using a discount card, you could get that drug
for $95. If you use your Medicare drug plan card, you will pay $100. If
you don't use your Medicare drug plan card and use the pharmacy's
savings card, you will pay $95. You can take advantage of the lower
price, and send your receipt to your drug plan. Your plan will count the
$95 toward your total out-of-pocket costs and total drug spending under
the plan.
(Source: U.S. Department of Health & Human Services)