Medicare beneficiaries spend a lot on prescription drugs.
With many senior citizens on fixed incomes, it is no wonder they are looking for ways to save.
Learn more about drug coupons, Medicare Part D, and how to know which option to use.
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Included in those amendments is theAnti-Kickback Statute(AKS).
Unfortunately, drug coupons and rebates fall into that category.
The AKS was enacted to prevent anyone from abusing the system.
In this way, Medicare is able to keep its costs down.
Unfortunately, this doesn’t necessarily help people who are trying to get their medications as soon as possible.
Pharmacy Gag Rules
It is perfectly legal to use drug coupons.
This confusion is a result of pharmacies that are not always forthcoming or totally clear about your options.
Pharmacy benefit managers(PBMs) act as “middle-men” who negotiate contracts between pharmacies and pharmaceutical companies.
In many states, part of this contract negotiation includes what is called a pharmacy gag rule.
This is not surprising when you realize that the PBMs are trying to protect their investments.
They want you to use the drugs on their formularies so that they can generate the most profit.
That could leave you to pay more than you’re gonna wanna.
Some states have taken action against this practice.
Connecticut, Georgia, Maine, and North Carolina banned pharmacy gag rules in 2017.
The federal government has also gotten involved.
In September of 2018, the United States Senate unanimously passed The Know the Lowest Price Act of 2018.
This legislation specifically prevents PBMs from setting up pharmacy gag clauses that would affect Medicare beneficiaries.
Using Drug Coupons vs.
Using Medicare
It is not always obvious when you should use a drug coupon instead of using Medicare.
You will need to make a decision based on your personal situation.
You Reach the Donut Hole
Part D plans have an unfortunate coverage gap.
That decreased coverage is commonly referred to as the donut hole.
In this case, using a drug coupon is something to consider.
Your best option is to get on a different Part D plan that better suits your needs.
You have a choice to make.
Either use the drug coupon or use your Part D drug planwhichever saves you the most money.
If you are unsure of what to do, talk to your pharmacist.
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Medicare.gov.Costs in the coverage gap.
Cubanski J, Neuman T.The Facts on Medicare Spending and Financing.
National Academy for State Health Policy.State Legislation that Bans Pharmacy Benefit Managers Gag Clauses.
