UNITED STATES—Toni: I had a great experience which helped me from getting in the Medicare Donut Hole with an expensive generic prescription. I received a generic prescription for Parkinson’s and when I went to my Plan D preferred pharmacy and was informed that the specific generic was not in my Part D plan’s formulary and would cost $460 per month. I then went to another pharmacy and was told the retail price was $199 per month.

I discussed my experience with a friend, and she told me about “GoodRx.com.” What a blessing! By entering my zip code, GoodRx gave me a printout of drug stores that sell the drug at a discounted price with no strings attached. I went to one on the list with the GoodRx coupon in hand. The cost for a one-month drug supply was only $43.00. How can the price of a generic drug range in price from $43 to $460?

Something is wrong with America’s prescription drug system. Tell your readers not to give up if they get an outrageous price for a drug. There are several web sites like GoodRx providing a similar service. You just have to do your homework! Sarah from Tulsa, OK.

Hi Sarah: Thank you for sending the Toni Says® Medicare team this information on GoodRx. America needs to be aware that you can use “cost saving prescription drug plans” like GoodRx, SingleCare, ScriptRelief, or other discount programs to help control the cost of your Medicare prescription drugs.

By not placing these expensive generic or brand name drugs on your Part D plan, you can keep from “getting in the Donut Hole” as fast or at all.

I personally had a generic antibiotic and allergy medication prescribed last week and when I went to pick them up using my own Medicare Part D plan, both generic prescriptions together were over $120. I remembered Sarah’s email about GoodRx and while sitting in the store’s parking lot, I looked online at GoodRx. The savings were around $58 with the antibiotic costing $30 and allergy med $28. I gave the pharmacist the GoodRx coupon on my phone and it worked! (Other pharmacies would have saved me more money, but the prescription had already been sent to that pharmacy.)

Next time, I will go to the GoodRx or another prescription discount site and do research on which pharmacy has the lowest price before I go to get my new prescription. And America needs to do the same to save on their prescriptions.

On its website, GoodRx claims, “that doctor offices nationwide recommend GoodRx to their patients and billions have been saved nationwide on prescription drug costs”. Visit Goodrx.com for more information.

Readers Part D Costs will be changing for 2024. Here is a summary:

  • Initial Deductible: $545
  • Initial Coverage Limit: $5,030 for 2024 where the 2024 “Donut Hole” begins.
  • Donut Hole Out of Pocket Costs: You will spend 25% of the brand name drug, the Drug company will spend 70% and the chosen Part D plan will spend 5% until the total spent of your prescriptions is $8000. Then the “Donut Hole” ends, and Catastrophic Coverage begins.
  • New Catastrophic Coverage Medicare Rule of $0 out of pocket begins Jan. 1, 2024: when a Medicare recipient enters Catastrophic Coverage, Medicare will pick up all cost of the prescriptions whether brand name or generic and those with a Medicare Part D plan pay $0.

On January 1 of each year, the process starts all over again with a new Medicare Prescription Drug plan and different costs, deductibles, and a new Donut Hole.

Need help understanding Medicare, Toni’s new Confused about Medicare video series is available for purchase at www.tonisays.com. Call the Toni Says® Medicare call center at 832-519-8664 or email info@tonisays.com with your Medicare questions.