Extra Help & Paying Less

Do drug discount cards work with Medicare?

Last reviewed: · Big Sioux Benefits Data Desk

You can use a discount card, but not alongside your Medicare drug plan on the same prescription, and there is a real cost to doing so. When you buy a drug with a discount card instead of through your plan, that spending does not count toward your Part D deductible and does not count toward your $2,100 annual out-of-pocket maximum (Medicare.gov).

The qualifier, and it is the more serious one: discount cards are not creditable drug coverage. Using one in place of a Part D plan means you are accumulating a late enrollment penalty for every month you go without real coverage, and that penalty is permanent. Medicare.gov makes this point explicitly about discount programs generally, including TrumpRx, which it describes as a place to compare cash prices rather than a form of coverage.

The trade-off

Buying through your planBuying with a discount card
Counts toward your deductibleYesNo
Counts toward the $2,100 capYesNo
Counts as creditable coverageYesNo
Price on a cheap genericYour tier copaySometimes lower
Price on an expensive brandUsually far lowerUsually much higher

The sensible way to use a discount card is narrow: an occasional cheap generic where the cash price genuinely beats your copay and you were never going to approach the cap anyway. The way to lose money is to route expensive drugs around your plan, which both costs more per fill and delays the point at which your covered drugs become free. If price is the pressure, compare the card price against your plan price, and look at Extra Help before treating a discount card as the solution.

Sources

Related questions

Is TrumpRx a replacement for Medicare drug coverage?

No. Medicare.gov presents it as a way to find special offers and compare the lowest cash price on prescription drugs, and states that it and other discount cards are not creditable coverage. Purchases made that way do not count toward your Medicare deductible or your out-of-pocket maximum.

Can I use a discount card and my plan on the same prescription?

No. A given fill goes through one or the other. That is why the choice matters: the cheaper sticker price today may cost you more across the year by not counting toward your deductible or your $2,100 cap.

Drug costs turn on your specific prescriptions, so the arithmetic is worth doing once, properly: book a free, no-pressure conversation, see your county's South Dakota plan lineup, or browse all answers. SHIINE, the state's free counseling program, is at 1-800-536-8197 and sells nothing.

Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or SHIINE (South Dakota's SHIP) for all of your options.

· Big Sioux Benefits Data Desk