Saving Money on Prescription Drugs When Your Parent's Not Covered by a Medicare Part D Plan

Quick summary

Most of us are painfully aware of the sky-high cost of prescription drugs. Your parent may be one of the many people 65 and over who have enrolled in a Medicare Part D prescription drug plan to offset those costs. But most Part D drug plans don't cover any drug costs during the program's "doughnut hole" -- when your parent's total drug expenses for the year reach $2,510 but his out-of-pocket costs for the year haven't yet reached $4,050. Or your parent might not be enrolled in a Part D drug plan. In either case, you'll want to find ways to save money on out-of-pocket prescription drug costs. A number of sources for discounted prescription drugs are described here.

Could my parent switch to a generic prescription drug?

Your parent may be taking a brand-name prescription drug that has a generic equivalent. In virtually all cases, there's no difference whatsoever in the active ingredients between generic and brand-name drugs. If a generic is available, it usually costs far less than the brand name. Your parent can check with his doctor or pharmacist to see whether a generic is available. The pharmacist can also tell him how much he would save by switching. If your parent has any doubts about whether the generic would work as well for him as the brand-name drug, he can ask his doctor.

Is there an equivalent prescription drug my parent could take?

Different companies within the pharmaceutical industry often produce virtually identical drugs under different brand names. One may be significantly cheaper than another. If your parent is taking a brand-name drug that has no generic equivalent, he can ask his doctor whether another company sells a nearly identical drug under a different name, then ask his pharmacist whether it's less expensive.

If there's no cheaper brand-name prescription drug with the same active ingredients, the doctor may know of a somewhat different drug also used to treat the same illness or condition. It may have come on the market after your parent began taking the other drug. Or maybe his doctor prescribed the other drug out of habit without considering an alternative. Your parent can ask his pharmacist whether there's a significantly cheaper option to the drug he is taking. If so, he can ask his doctor whether it's a good idea to try it. Your parent should ask whether the new drug is likely to be as effective as the one he is currently taking and what side effects it may have.

Can my parent get free sample drugs from his doctor?

Pharmaceutical companies constantly give doctors loads of free samples of the medications they sell. The reason is simple: They want the doctor to think of their prescription drugs when he's writing prescriptions. But they also want him to give away the samples to patients in the hope that the drug will be effective and the patient will continue to use it.

Doctors often give away a free drug sample to a patient who only needs one dose. Before your parent fills an expensive prescription, he should ask if his doctor has any samples.

Doctors also frequently give a sample to a patient who's trying out a prescription drug for the first time. But there's no reason a doctor can't give away a number of free samples to the same patient. If your parent is without prescription drug coverage for a period of time -- or example, when he's within the Medicare Part D "doughnut hole" -- he may want to ask whether his doctor could provide him with samples to tide him over until his coverage kicks in again.

Are there any state or local community assistance programs for my parent?

Some states and local communities have programs to help older people pay for a prescription drug when the drug or the patient isn't covered by a Medicare Part D plan or by Medicaid. Some of these programs offer discounts on all drugs, while others help only with certain common drugs. Often such programs limit their help to low-income, low-asset seniors. To qualify, your parent would need to provide evidence of his financial situation, which might include tax returns and bank, property, and investment statements.

Is my parent eligible for veterans' benefits drug coverage?

If your parent is a veteran, he may be eligible for free or low-cost medical care from the Department of Veterans Affairs (VA) healthcare providers. Different levels of VA coverage -- called "priority groups" -- are available to veterans with various types and eras of service, sources of medical condition, and financial status.

VA medical care can include free (for low-income veterans) or low-cost prescription drugs provided at a VA pharmacy. However, a VA doctor must prescribe these drugs. A veteran enrolled in Medicare is entitled to coverage for medical service from either the VA or Medicare but not both. So if your parent normally receives a prescription for a high-priced drug from a non-VA doctor, he would have to see a VA doctor to get the same prescription and have a VA pharmacy fill it at low or no cost.

To find out more about VA benefits, you can visit the Department of Veterans Affairs website. You can also call the general benefits phone service at 800-827-1000 or the health benefits service at 877-222-8387.

Is there a pharmaceutical company discount program for my parent's prescription drugs?

Some pharmaceutical companies have programs to help low-income seniors by providing certain medications at reduced costs. The programs usually have strict income guidelines and offer only small discounts on certain medicines. Still, even small savings on an expensive medicine can add up if your parent takes the drug regularly.

To get the reduced price, your parent must register directly with the pharmaceutical company's program. His doctor might also have to fill out papers required for enrollment in the program. And some programs provide the drug to the doctor, who then distributes it to your parent.

Are there any nonprofit or retail prescription drug discount programs my parent could join?

Some nonprofit organizations that cater to seniors or have large numbers of seniors in their membership have programs to help members get discounted prescription drugs. These include both national and state organizations, some connected to a particular professional, union, or fraternal group. There may be a membership fee, plus a co-payment for each prescription, and the total savings for any prescription is probably no more than 10 percent. But a 10 percent discount on an expensive medicine can be significant.

Many large pharmacy chains also set up programs to provide discounted prescription drugs for people with Medicare. These programs usually issue a membership card, which your parent must present each time he buys a drug at one of the chain's stores.

Can my parent get prescription drugs from Canada?

Hundreds of thousands of people in the United States buy prescription drugs online or by mail order, or travel to Canada from border states to fill their prescriptions. The total runs to billions of dollars a year. The reason? The Canadian healthcare system negotiates with the pharmaceutical companies for reduced prices. Anyone buying these drugs -- the same drugs that are sold in the United States for 50 to 80 percent more -- in Canada benefits from the discount. The law is murky on this subject; technically, U.S. Customs could seize such drugs, but in practice they almost never do.

To help your parents find a reliable Canadian source for prescription drugs, you need to take several steps. First find various options online by searching the Internet for "prescription drugs Canada." Then investigate any particular source by entering the name of the service in a search engine to look for reports of poor service or fraud. Check with any office of the nonprofit State Health Insurance Assistance Program (SHIP) or Health Insurance Counseling and Advocacy Program (HICAP) to vet the reputation of a Canadian pharmacy service that you and your parent are considering. You can find the number for a local office online or in the white pages of the phone directory under SHIP or HICAP. Finally, start small -- the first time, order only the smallest available amount of one medication. If that works out well, he can expand his orders to include other prescriptions or larger amounts.

How can I find prescription drug discount programs?

The Medicare website has a link called " Lower Your Costs During the Coverage Gap", which can direct you to several other links with information about state and local government and pharmaceutical company discount programs. You can get the same information by calling Medicare toll-free at 800-634-2273.

Free information on discount drugs is also available from the federal government's Area Agency on Aging, a clearinghouse for information about many issues concerning elders. To contact it, go to the Area Agency on Aging website or call 800-677-1116.

Some online clearinghouses for drug discount information can also direct you and your parent to pharmaceutical company, retail, and other drug assistance programs. Among them are Pharmaceutical Research and Manufacturers of America, the Medicine Program, and Volunteers in Health Care.