Guide to Medicare Part D: What If I Can't Afford My Drug?

 

If you have limited income and assets (i.e. savings and stocks), you may qualify for "extra help" with the cost of your drug.

NOTE: In order to receive "extra help," you MUST APPLY for it, UNLESS you are elderly or disabled AND enrolled in: Medicare and Medicaid(a Kentucky Medical Card), OR Medicare and one of the three Medicare Savings Programs, also known as QMB, SLMB, or QI, OR Medicare and SSI

If you are not eligible for any of these programs, you should apply for extra help through the Social Security Administration at 1-800-772-1213, or you may call the Legal HelpLine for Older Kentuckians at 1800-200-3633.

If you do not qualify for "extra help," contact your doctor.

Explain to your doctor that you cannot afford your drug. Find out whether your doctor will prescribe a substitute drug that you can afford.

If your doctor believes that you must have the prescribed drug, and there are similar drugs on your formulary that cost less, then ask your doctor to contact your Part D plan to request an "Exception" and to explain why your drug is medically necessary.

NOTE: You have a RIGHT to request an Exception in certain circumstances when you cannot afford your drug. For questions or advice, contact your nearest Kentucky legal services program.

Get more information about requesting an Exception.