Lower-Cost Alternatives When Your Medicare Prescription Drug Plan Gets Too Expensive

If you opened your Medicare Annual Notice of Change (ANOC) and discovered that your prescription drug plan is going to cost more in 2027, you may be wondering whether there is a more affordable option.

For people who take several medications, prescription drug coverage can be extremely important. But what if you only take one or two inexpensive prescriptions—or don't take any medications at all?

Paying a higher monthly premium for a plan you rarely use can be frustrating.

The good news is that you may have other options. Before you cancel your Medicare prescription drug coverage, take some time to compare plans and understand the consequences of going without Part D coverage.

At Utah Avenue Insurance, we help our Medicare clients review their prescription drug coverage every year so they can see what makes the most sense for their medications, pharmacies and budget.

Start by Looking for a Lower-Cost Medicare Part D Plan

If your current Medicare Part D plan is getting expensive, the first thing to consider is whether another standalone prescription drug plan may cost less.

Medicare Part D plans can have very different:

• Monthly premiums

• Deductibles

• Drug formularies

• Copays and coinsurance

• Preferred pharmacy networks

• Costs for specific medications

This is why we don't recommend choosing a plan based on the monthly premium alone.

A plan with a very low premium could end up costing you more if one of your medications is expensive under that plan. On the other hand, someone who takes few or no medications may have very different priorities.

The goal is to look at your estimated total annual cost, not just the premium.

Consider a Medicare Advantage Plan That Includes Prescription Drug Coverage

Another option for some Medicare beneficiaries is a Medicare Advantage plan that includes prescription drug coverage, commonly called an MA-PD plan.

Instead of having Original Medicare plus a separate Part D plan, an MA-PD plan combines Medicare medical and prescription drug benefits into one plan.

Depending on where you live, Medicare Advantage plans may be available with low or even $0 additional monthly plan premiums. However, that doesn't automatically make Medicare Advantage less expensive or a better fit.

Medicare Advantage plans can have provider networks, copays, prior authorization requirements and other rules that are different from Original Medicare.

Before changing plans, make sure you understand how the plan would affect both your doctors and your prescriptions.

See If You Qualify for Extra Help

If the cost of Medicare prescription drug coverage is becoming difficult to afford, you may also want to see whether you qualify for Medicare's Extra Help program.

Extra Help helps people with limited income and resources pay certain Medicare Part D costs, including premiums, deductibles, coinsurance and other prescription drug expenses.

Some people qualify automatically, while others need to apply.

If you think you may qualify, don't assume that your income is too high without checking the current eligibility requirements.

Can I Use a Prescription Discount Card Instead of Medicare Part D?

Prescription discount programs can sometimes provide excellent prices on certain medications.

Depending on the medication and pharmacy, you may occasionally find that a discount price is less expensive than the price available through your insurance.

These programs can be useful tools for reducing prescription costs.

But there is an important distinction:

A prescription discount card is not the same thing as Medicare Part D insurance.

Discount programs generally aren't insurance, and having access to discounted prescriptions does not necessarily give you creditable prescription drug coverage for Medicare purposes.

That distinction becomes very important if you're considering dropping your Medicare Part D plan.

Be Careful Before Dropping Part D Coverage

If you currently don't take medications, you might look at your monthly premium and think:

“Why don't I just cancel my drug plan and use a discount card if I ever need a prescription?”

Before doing that, make sure you understand Medicare's Part D late enrollment rules.

If you go 63 days or more in a row without Medicare drug coverage or other creditable prescription drug coverage after you're eligible, you could potentially owe a Part D late enrollment penalty when you enroll again later.

And this isn't necessarily a one-time penalty.

In many cases, the late enrollment penalty is added to your monthly Part D premium for as long as you have Medicare drug coverage.

We'll explain exactly how this penalty is calculated in our next article, but the important thing to remember is:

Don't cancel Medicare Part D simply because your prescriptions are inexpensive without first understanding the long-term consequences.

What About People Who Don't Take Any Prescriptions?

This is where comparing plans can become especially important.

If you currently take no medications, your priorities may be different from someone who takes several expensive prescriptions every month.

You may want to look for an affordable Part D option that allows you to maintain prescription drug coverage while protecting yourself in case your medication needs change during the year.

Remember, none of us know what prescriptions we may need six months or 6 years from now.

A new diagnosis, surgery, illness or other health change could result in medications you weren't expecting to take.

And you generally can't change your Medicare prescription drug plan whenever you want simply because you suddenly need an expensive medication. Medicare has specific enrollment periods and Special Enrollment Period rules.

Don't Forget to Compare Pharmacy Prices

Sometimes the plan isn't the only problem.

The pharmacy you use can significantly affect what you pay for your prescriptions.

Many Medicare Part D plans have preferred pharmacies where members receive lower cost-sharing.

Before switching plans, check what your medications would cost at several pharmacies in your area. Moving a prescription to a preferred pharmacy may sometimes make a meaningful difference in your annual prescription costs.

Look at the Whole Year, Not Just the Monthly Premium

When comparing your options for 2027, don't ask only:

“How much is this plan per month?”

Instead, look at the bigger picture:

Premium + deductible + estimated prescription costs = a much better picture of what the plan may actually cost you.

For someone who takes expensive medications, paying a little more in monthly premiums could potentially result in lower overall prescription costs.

For someone who takes few or no medications, a lower-premium plan may make more sense.

This is why Medicare prescription drug coverage should be compared based on the individual.

Your Prescription Drug Plan Got More Expensive. Now What?

If your Medicare prescription drug plan premium is increasing for 2027, don't assume your only choices are to pay the higher premium or cancel your drug coverage altogether.

There may be other options worth reviewing.

You may be able to find a lower-cost Part D plan. You may qualify for Extra Help. A Medicare Advantage plan with prescription drug coverage may be appropriate for your situation. And prescription discount programs may sometimes help lower the price of individual medications.

The right approach depends on your Medicare coverage, prescriptions, doctors, pharmacies and budget.

Let Utah Avenue Insurance Help You Compare Your Options

At Utah Avenue Insurance, our local Medicare agents can help you review your prescription drug coverage for 2027.

We can enter your current medications and preferred pharmacies, compare available Medicare prescription drug plans and help you understand the estimated costs associated with your options.

And if you're considering a Medicare Advantage plan with prescription drug coverage, we can help you look at the medical side of the plan too—including your doctors, hospitals and other benefits.

Don't drop your Medicare prescription drug coverage simply because the premium went up. Review your options first.

Schedule an appointment with a local Utah Avenue Insurance agent and let us help you find Medicare coverage that fits your needs and budget.

Better coverage starts here.