You may qualify for additional assistance to help cover the cost of prescription drugs. Review these plans, options, and resources.
Employer/Union Sponsored Plans
Many current or former employer/union sponsored Health Plans include prescription drug coverage that is considered “creditable (as good as or better) coverage” to a Medicare Part D prescription drug plan. The employer/union plan can provide documentation when the plans drug coverage is considered creditable coverage.
Prescription costs (premiums, co-pays) with the employer/union plan can be compared with Medicare Part D plan options. If the employer/union plan is not considered creditable coverage, a person may want to enroll in a Medicare Part D drug plan when first eligible to avoid a late enrollment penalty.
If a person has prescription drug coverage through an employer/union health plan and chooses to enroll in a Medicare Part D drug plan, this may actually put them at risk of losing the employer/union health coverage. A person should contact their employer health plan administrator for further information BEFORE enrolling in Medicare Part D and consider all options.
Federal Employee Health Benefits Program (FEHB)
This program provides health coverage for current and retired federal employees and covered family members. The FEHB plans include prescription drug coverage that is considered “creditable coverage” to a Medicare Part D prescription drug plan.
Veteran Benefits
This health program offers prescription drug coverage that is considered “creditable coverage” to a Medicare Part D prescription drug plan. A person does not need a Part D drug plan. If enrolled in both, a person cannot use both types of coverage for the same drug at the same time. It will be one plan or the other to cover the prescription drug.
TRICARE For Life (Military Health Benefits)
This health program offers prescription drug coverage that is considered “creditable coverage” to a Medicare Part D prescription drug plan. A person does not need a Part D drug plan to keep the TRICARE drug coverage. If enrolled in both drug coverage programs, Medicare Part D will be the primary payer and TRICARE pays second.
CHAMPVA (Civilian Health and Medical Program of the Department of Veteran Affairs)
This health program offers prescription drug coverage that is considered “creditable coverage” to a Medicare Part D prescription drug plan. A person does not need a Medicare Part D drug plan. If a person does enroll in Part D, they will not be able to use the CHAMPVA Meds by Mail program (in which a person can receive their maintenance drugs at no charge – no premium, deductible, or copayments).
Indian Health Services (IHS)
Indian Health Services is a federal health care program (not insurance) for American Indians and Alaska Natives with care being provided at IHS facilities. If a person receives health care from IHS, they have creditable prescription drug coverage. If a person enrolls in a Medicare Part D drug plan it may help the Indian health facility because the drug plan pays part of the cost of their prescriptions. This helps the Indian health provider with the cost of services.
Non-Creditable Prescription Resources
- Pharmaceutical Patient Assistance Programs (PAP’s) These prescription assistance programs are usually created/sponsored by pharmaceutical companies and offer discounted medicines to people who are unable to afford them. Each program has its own qualifiers for eligibility.
- Discount Cards and/or Coupon Programs (such as GoodRx or SingleCare) These programs are not insurance; they are prescription discount plans. Some programs may only work if a person has no other insurance while other cards or coupons may be used even if a person has prescription coverage, including Medicare Part D. Often, there is no co-pay. A person simply pays a discounted cash price for each prescription medicine. In some cases, this cost may be cheaper than their insurance co-pay.
- Canada/Mexico Mail Order Many prescriptions may cost less when ordered from pharmacies in Canada or Mexico. Caution should be used when utilizing these options. Before doing business with an online pharmacy, a person can confirm it is licensed in its country of origin and that the country has strong pharmacy regulations.
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