Extra Help & Paying Less
How do I lower my Medicare drug costs?
Last reviewed: · Big Sioux Benefits Data Desk
Start with Extra Help. It is the largest single reduction available in Medicare drug coverage, taking you to a $0 premium, a $0 deductible, and caps of $5.10 per generic and $12.65 per brand-name drug, and it is badly underclaimed because people assume they earn too much. Everything else on this list saves less.
The qualifier: these options are not interchangeable, and they solve different problems. Extra Help and Medicare Savings Programs address affordability. Comparing plans addresses a bad match between your drugs and your coverage. The Medicare Prescription Payment Plan addresses timing and nothing else. Working the list in order matters more than working all of it.
Ranked by how much they typically save
| Step | What it addresses | Typical impact |
|---|---|---|
| 1. Apply for Extra Help | Affordability, if income and resources are under the limits | Largest available, often thousands a year |
| 2. Apply for a Medicare Savings Program | Premiums and Medicare cost sharing | Part B premium alone is about $2,435 a year |
| 3. Compare plans against your actual drug list | Bad tier placement or a missing formulary drug | Can be hundreds a year |
| 4. Ask about generics or a lower-tier alternative | Expensive brand where an option exists | Often large, common generics run about $9 to $11 per fill |
| 5. Price 90-day and mail order fills | Maintenance drugs taken every month | Modest but recurring |
| 6. Check manufacturer patient assistance | Drugs your plan does not cover at all | Situational, sometimes total |
| 7. Use the Medicare Prescription Payment Plan | Timing, not total | No savings, spreads the same cost |
Two cautions on the tempting shortcuts. Discount cards can beat your copay on a cheap generic, but purchases do not count toward your deductible or the $2,100 cap and are not creditable coverage, covered in do discount cards work with Medicare. And never stop or ration a prescription on cost grounds without telling your prescriber, because there is nearly always a cheaper route they can find if they know the problem exists.
Free, unbiased help with all of this is available from SHIINE at 1-800-536-8197, and if you would rather talk it through with a local agency, we are glad to help at no cost to you. The coverage side of the decision is in Part D prescription drug plans.
Sources
- Medicare.gov — Help with drug costs (Extra Help) — 2026 limits and amounts; accessed 2026-08-21
- Medicare.gov — Costs for Medicare drug coverage — accessed 2026-08-21
- Medicare.gov — Medicare Prescription Payment Plan — accessed 2026-08-21
- SHIINE — South Dakota's State Health Insurance Assistance Program — accessed 2026-08-21
Related questions
What is the single biggest thing I can do to lower my drug costs?
Apply for Extra Help if there is any chance you qualify. The 2026 limits are $23,940 in income and $18,090 in resources for an individual, your home and car do not count, and the program takes you to a $0 premium and $0 deductible with generics capped at $5.10. Nothing else on the list comes close.
Should I switch plans every year?
You should re-check every year, which is not the same as switching every year. Plans change formularies, tiers, pharmacy networks, and premiums at the plan-year boundary, so the plan that fit your drugs last year may not this year. Compare against your actual drug list, then switch only if the comparison says to.
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.