Where the biggest savings come from

The largest single discount most seniors find comes from Medicare Part D, the prescription drug coverage that begins at age 65. If you are already on Medicare, you may not be using it yet — Part D is separate from Original Medicare and requires you to sign up during your enrollment window. The difference between the price you pay without it and with it is often 50 to 70 percent of the drug's cost.

If you have not yet turned 65, or if you are under 65 and on Medicare for another reason, Part D may still be available to you. The enrollment window is October 15 through December 7 each year. If you miss it and do not have other drug coverage, you pay a penalty when you do enroll — usually 1 percent of the national average premium per month you were late, added to your premium permanently.

Beyond Part D, the second-largest savings come from using a generic drug instead of a brand name, and from comparing prices between pharmacies. A generic drug contains the same active ingredient as the brand name version and works the same way, but costs 80 to 85 percent less on average. Prices for the same generic drug can vary by 200 percent or more between pharmacies in the same town.

Key Takeaways

  • Medicare Part D covers prescription drugs for people 65 and older, and you must sign up during the October 15 to December 7 enrollment window each year or pay a permanent penalty.
  • Generic drugs work identically to brand-name drugs but cost 80 to 85 percent less, and your doctor can usually switch you to a generic version with a straightforward request.
  • Pharmacy prices for the same drug vary widely — using a free price-comparison tool or calling three pharmacies can save you hundreds of dollars per year.
  • Programs like GoodRx, SingleCare, and manufacturer coupons can lower your out-of-pocket cost even if you have Part D, especially for drugs with high copays.
  • If your income is below 150 to 200 percent of the federal poverty line, you may may have access to for Extra Help, which covers most or all of your Part D costs.

How Medicare Part D works and what it costs

Part D is sold by private insurance companies approved by Medicare, not by Medicare itself. You choose a plan during your enrollment window, and coverage begins January 1. Each plan has a different list of covered drugs, different copays, and different monthly premiums. The average premium is around $30 to $40 per month, but plans range from $0 to over $100.

All Part D plans follow the same cost structure: you pay a copay or coinsurance for each prescription until you reach your deductible (usually $505 in 2024, though this changes yearly). After that, you pay coinsurance — typically 25 percent of the drug's cost — until your out-of-pocket spending reaches a threshold (around $5,050 in 2024). Once you cross that threshold, you enter "catastrophic coverage," where Medicare pays most of the cost and you pay a small copay. The exact numbers change each year, so check your plan's current details.

To find and compare Part D plans, use the official Medicare Plan Finder at Medicare.gov. You enter your drugs, your pharmacy, and your zip code, and it shows you every plan available to you, ranked by estimated yearly cost. This tool is free and is the most accurate way to see which plan will cost you the least for your specific medications.

Using generic drugs and asking your doctor to switch

A generic drug is chemically identical to the brand-name version and must pass the same FDA safety and effectiveness tests. The only real difference is the name on the bottle and the price. If your doctor prescribes a brand-name drug, you can ask them to switch you to the generic version — most doctors will do this when ready, either by calling the pharmacy or by writing a new prescription.

Some brand-name drugs do not yet have a generic version, usually because the patent has not expired. Your pharmacist can tell you whether a generic exists for your drug. If it does not, you can ask your doctor whether a different drug in the same class — one that does have a generic — might work for you instead.

If your doctor says you need the brand-name drug specifically, you can ask them to write "do not substitute" on the prescription. This tells the pharmacy you cannot use the generic. However, this usually means you will pay much more out of pocket, so discuss the cost with your doctor before they write it.

Comparing pharmacy prices and using discount programs

The same generic drug can cost $20 at one pharmacy and $60 at another, even in the same neighborhood. Before you fill a prescription, use a free price-comparison tool like GoodRx, SingleCare, or RxSaver. You enter the drug name, dose, and quantity, and the tool shows you prices at every pharmacy near you. You can often use these discounts even if you have Part D — you choose whether to use your insurance or the discount code, whichever costs less.

Some pharmacies offer their own discount programs. Walmart, for example, offers many generic drugs for $4 for a month's supply or $10 for three months. Target, Kroger, and other chains have similar programs. Ask your pharmacist whether your pharmacy has a discount program for the drugs you take regularly.

Manufacturer coupons can also lower your cost. If a drug company makes the medication you take, search the drug's name plus "coupon" online, or ask your doctor's office — they often have printed coupons from drug companies. These coupons typically cover the copay or coinsurance you would pay, up to a certain amount per month.

Extra Help for people with lower incomes

If your income is below 150 to 200 percent of the federal poverty line (the exact threshold depends on your state and household size), you may may have access to for Extra Help, a federal program that pays most or all of your Part D costs. For 2024, 150 percent of the poverty line is roughly $2,100 per month for a single person, though this varies by state.

To explore for Extra Help, contact your local Social Security office, call Social Security at 1-800-772-1213, or explore online at SSA.gov. You will need to provide proof of income and resources. The process takes about 15 minutes. If you may have access to, Extra Help covers your Part D premium, deductible, and most of your copays — you typically pay $1 to $3 per prescription.

Many seniors who may have access to for Extra Help do not know about it. If your income is tight, it is worth checking whether you may have access to. Social Security can tell you in one call.

Prescription information programs run by drug manufacturers

Most large pharmaceutical companies run programs that provide free or low-cost drugs to people who cannot afford them. These programs are separate from Part D and manufacturer coupons. To find out whether the drug company that makes your medication has an information program, search the drug name plus "patient information program" online, or call the company's customer service number (usually on the drug's website).

may be able to access for these programs usually depends on your income and whether you have insurance. Some programs require you to have tried Part D first. The process process varies — some take a few days, others take a few weeks. If you are approved, the drug company typically mails your medication directly to you or to your doctor's office.

These programs exist because drug companies want to may support people can afford their medications. If you cannot afford a drug even with Part D and discounts, it is worth calling the manufacturer to ask what options exist.

Timing your enrollment and avoiding penalties

Part D enrollment happens once a year during the open enrollment period, October 15 through December 7. If you turn 65, you have a seven-month window starting the month you turn 65 to sign up without penalty. If you miss this window and do not have other drug coverage, you will pay a permanent penalty — 1 percent of the national average Part D premium per month you were late, added to your premium for as long as you have Part D.

If you already have Part D, you can switch plans during open enrollment each year. Many people's costs change from year to year because drug prices change, plan premiums change, and formularies (the list of covered drugs) change. It is worth checking the Medicare Plan Finder every October to see whether a different plan would cost you less.

If you have other drug coverage — through a current or former employer, a union, or Veterans Affairs — you may not need Part D. However, if that coverage ends, you have 63 days to sign up for Part D without penalty. Mark the date your coverage ends on your calendar so you do not miss this window.

Frequently Asked Questions

Can I use a GoodRx coupon if I have Medicare Part D?

Yes. At the pharmacy, you can choose to use either your Part D insurance or the GoodRx discount code — whichever costs you less out of pocket. The pharmacy will process whichever one you choose. This is legal and happens thousands of times per day.

What if my doctor says I need the brand-name drug instead of the generic?

Ask your doctor why. If there is a medical reason — for example, you have had a bad reaction to the generic — they can write "do not substitute" on the prescription. However, this usually means you pay significantly more. Discuss the cost with your doctor before they write it, and ask whether a different drug in the same class might work instead.

I missed the Part D enrollment window. Can I still sign up?

You can sign up anytime, but you will pay a permanent penalty if you did not have other drug coverage during the time you were uninsured. The penalty is 1 percent of the national average Part D premium per month you were late. Contact Medicare at 1-800-MEDICARE or visit Medicare.gov to enroll now and ask what your penalty will be.

How do I know if I may have access to for Extra Help?

Extra Help is available if your income is below 150 to 200 percent of the federal poverty line, depending on your state. For 2024, that is roughly $2,100 per month for a single person. Call Social Security at 1-800-772-1213 to find out whether you may have access to — they can tell you in one call and help you explore if you do.

Do I have to use the same pharmacy every time?

No. You can use any pharmacy that accepts your Part D plan. Prices vary between pharmacies, so it is worth comparing prices at different locations before you fill a prescription, especially for drugs you take regularly or in large quantities.