Wednesday, November 23, 2016

IBM Medicare 2016 Prescription Discount Cards

During Medicare open enrollment advertisements abound about Medicare Advantage Plans, Medicare Supplement plans, part D drug insurance plans and ... prescription discount cards.  What do prescription discount cards have to do with Medicare?  Absolutely nothing. Prescription discount cards ARE NOT Medicare part D insurance plans.  They are not insurance plans at all.  They are not regulated except for laws about false advertising and fraud. They are merely a way to maybe get prescription drugs at a discount.  You have to buy a part D insurance plan if you want Medicare drug insurance.  Reminder, if you don't buy a part D insurance plan you will pay a 1% per month penalty for every month you don't have the insurance and only can buy it during the fall to be effective January of the next year.
However, prescription discount cards might be useful for Medicare recipients.  What are they?  The best explanation I have come across was written by an organization called NeedyMeds.   This is an organization I often recommend as they are dedicated to helping people reduce their prescription drug costs.  The organization website is  On that site you can get their prescription discount card.
When might you use a prescription discount card instead of your part D insurance?  The best reason is when you get a new prescription and it is not on your part D plan's formulary.  Another possible reason is the prescription discount card actually gives you a better price for the drug than the copay you'd have to pay using your part D plan.  However, if you do use the discount card instead of your part D insurance then the cost of that drug will not be included in your out of pocket cost calculation for your part D insurance and will affect when you enter or exit the doughnut hole.  I believe IBM's catastrophic drug benefit will similarly not include it.
Obviously, when a drug is not covered by your plan then the only choice you have is to try to get a discount to reduce your cost.  Manufacturer discount coupons are usually better than prescription discount cards.  However, they frequently have expiration dates.  You can usually find those coupons by googling the drug. There are also low income assistance programs offered by a lot of drug companies.  You can find them through the needymeds website.  Although your prescription discount card might not expire (I believe most don't), the discount you receive can vary from use to use and/or from pharmacy to pharmacy.  Not all pharmacies accept a given discount card.  I suggest trying several different discount cards with a pharmacy to see if one is better than another each time you refill a prescription not covered by your part D plan.  There is a wrinkle to that suggestion.  Some pharmacies won't do it. Try to go to the pharmacy when they are not busy and they might be willing to check several cards.

There is one more caveat about using a prescription discount card.  The pharmacy might make a mistake and use the discount card instead of your part D plan.  In one case, I helped someone whose pharmacy even told the part D insurance that the client was canceling his part D insurance because they thought the prescription discount card was his new insurance (the pharmacist was new). The client then faced a part D penalty as well as dramatic drug cost increases.  It took a lot of unwinding to fix the problem and get the pharmacy to reimburse the client.  After knowing that, I never use a discount card in the same pharmacy where I use my part D insurance.  The problem is you won't get any advice about drug interactions.
Who provides prescription discount cards?  As I said, has one.  So do AARP and AAA. There are LOTS of other discount card providers but I won't list them because I don't know anything about the organization nor the legitimacy of the card.  I do know that some have been sued for false advertising. NEVER pay for a prescription discount card.  They are always "free" for the user.

Here are some other sources of  information about prescription discount cards:

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