Toni Says: Using GoodRX with Medicare Part D?

Published 12:01 am Saturday, January 15, 2022

Toni:

         I am a weekly follower of the Toni Says® Medicare column and have had a wonderful Medicare experience which helped to save me from getting in the Donut hole with an expensive generic prescription.

         I received a generic prescription for my Parkinson’s disease. When I went to my Plan D preferred Walgreens pharmacy and was informed that specific generic was not in my Part D plans formulary and would cost $460 per month. I then went to Kroger and was told the retail price was $199 per month.

         When I discussed my experience to a friend, she told me about a web site “GoodRX.com.” What a blessing this was! GoodRX.com gave me a printout of drug stores which sell the drug at a discounted price by entering my zip code with no strings attached

I went to Wal-Mart with the GoodRX coupon in hand. Wal-Mart’s cost for one-month drug supply was only $43.00.

         How can the price of a generic drug range in price from $43to $460? Something is wrong with our American 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 which provide a similar service. Just do your homework!

Julia from Arizona

Julia:

Thank you for sending the Toni Says® Medicare team this information on GoodRX. America needs to be aware that one can use “cost saving prescription drug plans” like GoodRX or a prescription drug discount program to help one control the cost of one’s Medicare prescription drug. By not placing these on your Part D plan can keep one from not “getting in the Donut Hole” as fast.

I had a generic antibiotic and allergy medication prescribed last week and when I went to pick them up, they were over $120 for generics. I remembered Julia’s email about GoodRX.com.

I looked online at GoodRX to check the cost at HEB, and the savings was over $68. The antibiotic was $30 and allergy med were $28. Other pharmacies would have saved more money so Next time, I will go to the GoodRX.com site and do research on which pharmacy has the lowest price.

For a fantastic way to start 2022 is to visit www.goodrx.com/medicare and search their Medicare section to help make the cost of expensive and common prescriptions whether generic or brand name affordable. This way one might avoid or delay the famous “Donut Hole.”

The GoodRX Medicare site will search Part D drug prices at pharmacies in your zip code that may be less than your Part D co-pay — especially if a drug is not covered by your Part D plan.      GoodRX is 100% free and no personal information is required.

2022 Medicare Part D costs are below:

  • Initial Deductible: $480
  • Initial Coverage Limit: $4,430 for 2022 where the 2022 “Donut Hole” begins.
  • 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 spend of your prescriptions is $7,050.
  • Catastrophic Coverage: Once the $7,050 has been spent, you will enter Catastrophic Coverage phase where your “covered” generic prescription drugs co pays are $3.95 or 5% of the “covered” generic prescriptions above $79 cost or for “covered” brand name prescriptions the co pays are $9.85 or 5% of the “covered” brand name prescription drugs above $197 cost.

Please email the Toni Says® Medicare team at info@tonisays.com or call 832.519-8664 regarding how using GoodRX can help control your Medicare Part D costs or for Medicare questions. The 2022 Confused about Medicare Zoom webinar is Thursday, February 10 at 4 p.m. Visit www.tonisays.com to sign up for Toni’s online webinar event.