Medicare Prescription Coverage: What It Includes and How to Save on Meds

When you're on Medicare prescription coverage, the part of Medicare that pays for outpatient prescription drugs, typically through Part D plans. Also known as Medicare Part D, it's not automatic—you have to sign up separately, and what you get depends on your plan, pharmacy, and income. Many people think Medicare covers all their meds, but that’s not true. Without Part D, you pay full price for everything from insulin to blood pressure pills. Even with it, you might still face high out-of-pocket costs—especially if you take multiple drugs or hit the coverage gap, also called the donut hole.

That’s where Medicare Extra Help, a federal program that lowers drug costs for people with limited income and resources. Also known as Low-Income Subsidy, it can cut your monthly premiums, annual deductibles, and copays by up to 90%. You don’t have to be on Medicaid to qualify. If you’re on Social Security and make less than $21,000 a year (or $28,000 for couples), you might already be enrolled without knowing it. If not, applying takes less than 10 minutes online. And even if you make too much for Extra Help, there are still ways to save: pharmacy discount cards, manufacturer coupons, and generic drug programs can slash costs on meds like metformin, lisinopril, or atorvastatin.

Not all drugs are treated the same under your plan. Some plans put expensive brand-name drugs in higher tiers, forcing you to pay more. Others have strict rules—like requiring you to try a cheaper generic first. That’s why checking your plan’s formulary every year matters. A drug that was covered last year might not be this year. And if you’re on long-term steroids, blood thinners, or diabetes meds, you’re especially vulnerable to cost spikes. That’s why many people turn to copay assistance, programs run by drug makers or nonprofits that pay part of your out-of-pocket cost for brand-name or specialty drugs. Also known as patient assistance programs, these aren’t for everyone, but they can make a huge difference if you’re paying hundreds a month. These programs often work alongside Medicare, not instead of it. You can use them even if you’re on a Medicare Advantage plan.

What you’ll find in the posts below are real, practical guides on how to navigate this system. You’ll see how people cut their insulin costs with generic alternatives, how to apply for Extra Help without getting lost in paperwork, and why some Medicare Part D plans are better for people taking multiple meds than others. You’ll also learn about hidden traps—like how switching pharmacies can suddenly make your $50 pill cost $200, or why grapefruit juice can wreck your blood pressure meds even if you’re on Medicare. These aren’t theoretical tips. They’re what real people used to save hundreds, sometimes thousands, a year. Whether you’re helping a parent, managing your own meds, or just trying to understand why your prescription bill keeps going up, this collection gives you the straight facts—no fluff, no sales pitch, just what works.