Find financial help · Lesson 13 of 16
How can I lower what I pay for prescriptions?
The short answer
Start by asking your pharmacist or prescriber about a lower-cost option, such as a generic. Then match the help to your coverage. Drug-maker coupons usually cannot be used with Medicare or Medicaid, but Extra Help, patient assistance programs, and independent charities may help.
Key takeaways
- Ask about a generic or another lower-cost drug before you pay.
- Drug-maker coupons are mainly for people with private insurance or no insurance.
- With Medicare, Extra Help can lower costs a lot, and yearly drug costs have a limit.
Prices for the same medicine can differ a lot. These steps go from simplest to most involved.
1. Ask at the pharmacy
Ask whether a generic or a lower-cost drug that works the same way is available. Ask the price with your insurance and without it. Sometimes the cash price is lower, but cash payments may not count toward your deductible.
2. Check your plan's drug list
Your plan's drug list shows which drugs are covered and at what cost. If your drug is not covered or costs a lot, ask your prescriber whether a covered drug would work, or whether to ask the plan for an exception.
3. Use the right kind of help
- Drug-maker coupons and copay cards lower your share at the pharmacy. They usually cannot be used with Medicare, Medicaid, or other government plans.[1]
- Patient assistance programs from drug makers may give medicine at low or no cost to people who qualify by income. Apply on the official program page.
- Independent charities may help with costs for a condition, whatever medicine you take. People with Medicare may be able to use them.[1]
- Discount cards give a cash price. They are not insurance.
4. If you have Medicare
Extra Help lowers drug costs for people with limited income and savings. You get it automatically with full Medicaid, a Medicare Savings Program, or SSI. Anyone else can apply through Social Security at any time.[2] In 2026, out-of-pocket costs for covered drugs are capped at $2,100 for the year. The Medicare Prescription Payment Plan spreads those costs into monthly bills, but it does not lower them.[3]
5. Buy online safely
Use only online pharmacies licensed in your state. The FDA's BeSafeRx page explains how to check.[4]
What can be different for you
Plans cover different drugs at different prices, and drug lists can change each year. Patient assistance programs and charities set their own rules, and charity funds for a condition can open and close. Extra Help is not available in the U.S. territories. Some states have their own programs that help pay for medicine.
More detail (optional)
Extra Help numbers
For 2026, the income limit is $23,940 for one person and $32,460 for a married couple. The limits on savings and other resources are $18,090 and $36,100. In 2027, people with Extra Help pay no more than $5.80 for each generic and $14.40 for each brand-name drug. Applying for Extra Help also starts an application for a Medicare Savings Program unless you say no.[2]
Free Medicare counseling
Your State Health Insurance Assistance Program (SHIP) gives free, unbiased help choosing drug coverage and applying for Extra Help.[2]
When the payment plan may not help
The Medicare Prescription Payment Plan may not be the best choice if your drug costs are low or about the same each month, if you join late in the year, or if you get Extra Help.[3]
Words in this lesson
- Extra Help
- A Medicare program that helps people with limited income and savings pay for Medicare drug coverage. It is also called the Low-Income Subsidy (LIS).
- Formulary (drug list)
- The list of medicines your plan covers, often grouped into tiers with different costs.
- Deductible
- The amount you pay for covered care each plan year before your plan starts to share most costs.
- Medicare
- Federal health insurance for people 65 and older and for some younger people with disabilities or certain conditions.
Related
Where can I go for help?
Free help is often close by: the member services number on your insurance card, the billing office for your provider, your state insurance department, and nonprofit patient advocates.
Who can help, and what each one does
Prefer personal support? An independent patient advocate may help. Learn about Navigator & request beta access (Navigator is in development.)
This is general education. For decisions about your own plan, taxes, or legal rights, check your plan documents or a qualified professional.