[25 -52 Solution Series] – Savings – Drug Coupons, Assistance Programs, and Medicare

As we age, health continues to be an essential topic. Either we are maintaining it with wellness programs through diet and exercise or managing diagnosed conditions with medication. Commonly, the costs of prescription drugs come up in conversation for many folks over age 50. Particularly the options and strategies for managing those costs for medications needed for managing their health.

We thought it would be helpful to distinguish the primary difference between coupons and patient assistance programs – two popular programs. That way, people understand which cost management programs can help when they go on Medicare. In addition, prescription drug costs become another topic to discuss with a Certified Medicare Planner® when planning for Medicare transition – whether the coupon benefits yield value for deferring Medicare enrollment. 

Manufacturers’ Coupons

One popular cost management solution for folks on commercial/group insurance is to use manufacturers’ coupons or copay coupons to reduce the cost of specific high-cost prescriptions to a more reasonable flat price. Coupons can easily be found online or provided to patients by a doctor. While coupons are actually a marketing strategy to entice utilization over competitors’ products, folks can surely benefit from the savings those coupons offer. However, keep in mind that coupons may have a use limit, and some states don’t allow them unless a generic alternative is not available. 

So manufacturer coupons are great! But when folks transition to federal health programs like Medicare, they are prohibited from using those coupons. However, there are other options in the form of ‘assistance’ that people can look into for helping them manage high-cost prescriptions by lowering out-of-pocket costs.

Patient Assistance Programs

Drug manufacturers, nonprofit groups, or state government agencies offer patient assistance programs. Unlike coupons, patient assistance programs typically require an application process. In addition, these programs are generally based on a consumer’s financial needs, although not always as strict in qualifications as many other financial assistance programs. 

The group issuing the program sets the qualifications needed to receive the assistance. So it sometimes takes a bit more time and research to find a program that can help, but worth it in lowering the expense and helping the person adhere to their treatment. 

Certified Medicare Planners® are an ideal resource to guide on places to reduce your out-of-pocket expenses for prescriptions. We recommend that employees not transition without experts’ help to lead them through the ins and outs of moving from a group plan to Medicare and maximizing their benefits. ALSO, Certified Medicare Planners® offer educational support, non-bias plan comparisons, and annual plan reviews, so benefits continue to meet the needs of their clients. That way, employees choose plans with confidence when they retire. And best of all, they can thank YOU for providing them with stress-free expert Medicare transition.

If Medicare feels a bit confusing, we get it! 

That’s why we are here to help make Medicare@Work easier! An employee can find greater confidence about when to enroll in Medicare by consulting with a Medicare expert like a Certified Medicare Planner®. …And whether they should wait and keep their employer group plan also. Every situation is different.

Medicare guidance for your employees in 2021.

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– Lora