Can I Get Prescription Help on Medicare? What to Know

Rising drug costs can make it difficult to afford even necessary prescriptions.

Even if you are on a fixed income, you shouldn’t need to ration medications, skip doses, or avoid taking the medications you need. There are a number of programs available that provide prescription help for seniors on Medicare.

Key Takeaways

• The Medicare Extra Help program assists low-income seniors. It can lower or cover costs related to Medicare Part D, which is Medicare’s prescription coverage plan.

• Many drug manufacturers and pharmacies offer programs that provide cost savings on prescriptions.

• Your doctor can prescribe a generic version of your medication. They may also suggest a different treatment to lower your prescription costs.

How can seniors get prescription help with Medicare?

While Medicare Part D helps cover the cost of prescription medications, it comes with other expenses like premiums and copays. If you have a low income, you may benefit from programs that provide prescription help for seniors on Medicare.

Medicare Extra Help program (Low-Income Subsidy)

Extra Help is a Medicare program. It assists low-income individuals with costs related to Medicare Part D. This includes premiums, deductibles, copayments, and coinsurance for prescription coverage. With Extra Help, you pay no more than $12.15 for each brand-name drug and $4.90 for each generic drug from participating pharmacies. 

Some individuals qualify for Extra Help automatically. This includes those who:

• Have full Medicaid coverage

• Are in a Medicare Savings Program (MSP) that pays their Part B premiums

• Receive Supplemental Security Income (SSI) from Social Security

If your income is below a certain amount, you can also apply for Medicare Extra Help. For 2025, these numbers are:

• Income under $23,475 and a resource limit of $17,600 for individuals

• Income under $31,725 and a resource limit of $35,130 for married couples

Medicare Savings Program (MSP)

Original Medicare (Parts A and B) usually doesn’t cover prescription drugs. However, Part A covers prescriptions given to inpatients in the hospital. Part B covers prescriptions from your doctor’s office, like injectables.

A Medicare Savings Program (MSP) can help pay your Part A and Part B premiums. Some individuals may also qualify for help with Part A and Part B deductibles, coinsurance, and copayments. 

For individuals enrolled under Extra Help and the Qualified Medicare Beneficiary (QMB) Medicare Savings Program who also receive full Medicaid coverage, covered drugs will cost no more than $4.80 per drug. 

State Pharmaceutical Assistance Programs (SPAPs)

SPAPs are programs run by the state. They help people with prescriptions if they meet certain conditions. To qualify, you’ll usually need to be at least 65 years of age, a resident of the state, and meet certain income requirements. Some programs may also require you to be enrolled in Medicare Part D.

SPAPs can vary widely by state, so it’s best to review your state’s programs. The National Conference of State Legislatures provides a list of state SPAPs and discount Rx programs.

Prescription assistance beyond Medicare

Pharmaceutical company patient assistance programs, non-profit organizations, and pharmacy discount programs can provide additional help in affording medications.

Pharmaceutical

Many pharmaceutical companies have discount programs to help low-income individuals receive free or discounted prescriptions.

To qualify for these programs, you usually need a prescription from a healthcare provider. You must also meet income requirements and have little or no insurance. To find these programs, you can perform a web search for “[name of drug] patient assistance program.” You can also use a database like the Medicine Assistance Tool (MAT) or NeedyMeds.

Non-profit

Several non-profits help seniors with medications. These include:

• PAN Foundation: Grants for medication copays, insurance premiums, and transportation. Funds are specific to certain medical conditions.

• HealthWell Foundation: Assists with copays, premiums, deductibles, and out-of-pocket costs for treatments and medications. Funds are specific to certain medical conditions and prescriptions. You must also have some form of insurance and meet their income requirements.

• The Assistance Fund: Helps with copayments, coinsurance, deductibles, and premiums. Almost 100 medical conditions are covered. A basic insurance — private or government-funded — is necessary to be eligible.

• Good Days: Copay, premium, diagnostic testing, and travel assistance for individuals living with specific chronic and life-altering diseases.

• CancerCare Copayment Assistance Foundation: Supports cancer patients by covering co-pays for their prescribed treatments. Assistance may depend upon available funding for different categories of cancer diagnoses. 

• Leukemia and Lymphoma Society Co-Pay Assistance Program: Helps with copays and coinsurance for prescription drugs and medical tests. They may also assist with insurance premiums. The grant amount varies by disease fund. 

• RareCare Patient Assistance Program: Helps patients living with rare diseases obtain life-saving and life-sustaining medications. The program also helps with insurance premiums and copays, diagnostic testing, and travel. It may also offer caregiver respite. 

• Rx Outreach: A non-profit mail-order pharmacy that is often able to offer medications at a lower cost than retail pharmacies. Some medications are even offered for free, and the rest must be purchased out-of-pocket. Having insurance is not a prerequisite. 

Pharmacy discount programs

Some pharmacies also offer discount programs that can reduce the cost of your medications. Here are some examples:

• Walmart’s Low-Cost Prescription Program: Offers some generic drugs at affordable prices. 30-day supplies start at $4 and 90-day supplies start at $10.

• Costco Member Prescription Program: Provides prescription savings to Costco members. The purchase must be from a participating pharmacy.

• Amazon’s Pharmacy RxPass: Provides $5/month prescriptions to Amazon Prime members on Medicare. There are currently 60 eligible prescriptions available through the program. 

There are also card discount programs, which can be used at multiple pharmacies. These include:

• GoodRx Prescription Savings Card: Offers up to 80% off your medications and works at over 70,000 U.S. pharmacies. There is no fee for the card.

• SingleCare Drug Discount Card: Offers up to 80% off your medications. You’ll search for your pharmacy to generate your card. There is no fee for the card.

• NeedyMeds Drug Discount Card: Offers up to 80% off medications. While you can print off a card for free, NeedyMeds asks that you send in a self-addressed, stamped envelope to receive a physical card.

Card discount programs offer prescription discounts on pharmacy retail rates and cannot be availed on insurance rates. 

How to reduce prescription costs on Medicare

There are several ways to reduce prescription costs on Medicare to make it more affordable.

Choosing the right Medicare Part D plan

Choosing a Medicare Part D plan can seem overwhelming, but there are tools to help you compare plans. To start, make a list of all your current medications, including their names, doses, frequencies, and the pharmacies that you prefer.

Then, take this information to Medicare’s Plan Comparison Tool and enter your zip code. There will also be a place for you to enter your medications to compare drug costs. When comparing Medicare Part D plans, you’ll want to consider:

• Premiums

• Deductibles

• Copay/coinsurance

• Coverage Gap

• Catastrophic Coverage

You’ll also want to check that your pharmacy is in-network. You can check the plan’s star rating, as each plan is rated based on a ranking of 5 stars. This can help you learn more about the plan’s customer service, customer experience, and pricing accuracy.

Working with healthcare providers to reduce costs

Working with healthcare providers, like doctors and pharmacists, can cut your medication costs. They can help you by:

• Switching to a generic version of your medication

• Changing the dosage or supply

• Prescribing a similar medication from the same drug class 

• Changing the formulation to comply with what is covered by insurance

• Providing medication samples free of cost

However, any prescription changes should only be made by your registered healthcare provider. 

Smart prescription shopping strategies

Checking prescription prices at different pharmacies is a smart way to save money. There are a few tools that you can use to do this, including:

• GoodRx: Compares the cost of medication at up to 70,000 U.S. pharmacies. When comparison shopping for your medication, you can also access coupons and learn more about patient assistance funds for the medications that you are taking.

• RxSavers: Helps you find the most affordable pharmacy to get your prescription filled near you. RxSavers also offers free coupons for medications.

• WellRx: Compares the cost of medication at up to 65,000 pharmacies across the U.S. Savings average 65%. 

It can also be helpful to compare discount options against your insurance. In some cases, it may be more affordable to use your pharmacy discount program rather than your insurance.

You can ask your pharmacist to check your discount card/coupon and insurance to determine which is more cost-effective.

Getting help navigating prescription assistance programs

Navigating prescription assistance programs can seem overwhelming, but there are a number of resources to help. Before you start asking for help, it’s best to gather your information. This includes:

• Your current medications and dosages

• Income details, such as your tax return

• Insurance status and information

• Doctor’s name and contact information

Resources to help:

• Pharmacist: Your pharmacist can check your medications. They’ll see if there are cheaper generic options or similar medications that cost less. They can also help navigate your insurance benefits to help ensure that you are maximizing your coverage.

• Doctor: Your doctor can prescribe you the generic version of a medication or a more cost-friendly alternative. They can also write prior authorizations to help you get coverage for necessary medications.

• Area on Aging: Your local Area on Aging can help you find SPAPs, nonprofits, and pharmaceutical company assistance programs to make your prescriptions more affordable. They can also help you apply for additional benefits, like Extra Help. 

• Social Worker: A social worker can help coordinate with pharmacies, your doctor, and your insurance company to help you get the most affordable medications. They can also identify helpful programs and nonprofits and help you apply for these benefits.

Bottom line

Prescriptions can be expensive, and it can be difficult to know how you are going to afford the prescriptions you need. However, there are a number of programs that can help. Medicare and state programs can help lower your prescription costs.

Pharmaceutical, non-profit, and pharmacy discount programs can help make your prescriptions more affordable. Talking with your doctor or pharmacist can help you explore these programs and find the best one for you.

Frequently asked questions

What is the Extra Help program for Medicare prescriptions?

Extra Help helps to cover the costs of premiums, deductibles, copays, and coinsurance for Medicare Part D, Medicare’s prescription program. You can qualify for Extra Help if your income is below a certain amount.

How do I qualify for prescription assistance with Medicare?

To qualify for prescription assistance with Medicare, you need to meet certain income requirements. In 2025, this is under $23,475 in income and $17,600 resource limit for individuals and under $31,725 in income and $35,130 resource limit for married couples.

Can I get extra help paying for prescriptions not covered by Medicare?

State pharmaceutical assistance programs (SPAPs) can help you pay for your prescriptions. Pharmaceutical, non-profit, and pharmacy assistance programs can also help.