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Medicare Advantage Members Medication Cost Reduction Tips

Drug Coverage – Medication Cost Reduction Tips

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Check the Formulary

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There may be a different medication that will treat your condition that is in a lower tier which may cost you less every month. Show the formulary to your doctor. Your doctor can help find the cheapest medication that is right for you.

Quartz Rx

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Use the Quartz Rx pharmacy benefit tool to find opportunities to find savings opportunities.  There may be alternative medications and/or pharmacies that you could use to reduce your out-of-pocket costs on medication.   Learn more about Quartz Rx.

Tier Exception Request

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Quartz Medicare Advantage has different drug tiers. If your doctor has prescribed a drug in a more expensive tier, you might be able to pay a lower tier cost if you can show that – The lower-tiered drug options would not work as well as the prescribed drug and/or that using the lower tier would likely cause medical problems. Your doctor would need to include that information and may send it to us by filling out a Medicare Prescription Drug Coverage Determination Form. Note: drugs in Tier 5 (Specialty) are not eligible for a Tier Exception.

Extra Help

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If you have a limited income, Medicare has a program that can help: Extra Help

This program can help you pay for Medicare prescriptions. It may even help with premiums, deductibles and coinsurance. For more information, do one of the following:

  1. Visit socialsecurity.gov/prescriptionhelp (By clicking on this link, you will leave the Quartz Medicare Advantage website)
  2. Call (800) 772-1213 (TTY users call (800) 325-0778)
  3. Apply in person at the local Social Security office.

Be sure to fill out the Extra Help application to find out if you qualify for other subsidy programs.

Social Worker

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Your doctor’s office or healthcare center may have a social worker available. Social workers can help you find ways to save money on medicine.

Manufacturer’s Pharmaceutical Assistance Programs

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Some drug manufacturers will provide medication at no charge to those who are eligible for their program. If you qualify, the manufacturer will mail the medications to you or your doctor’s office.

Learn more… (By clicking on this link, you will leave the Quartz Medicare Advantage website)

State Pharmaceutical Assistance Programs (SPAPs)

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Many states offer help paying drug plan premiums and / or other drug costs.

Learn more: medicare.gov/pharmaceutical-assistance-program/state-programs.aspx (By clicking on this link, you will leave the Quartz Medicare Advantage website.)

Aging & Disability Resource Centers and Similar Programs

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The ADRC (and similar programs) may offer benefits specialists and social workers who can help you answer medication coverage questions and concerns regarding ability to pay, housing questions, assistance with forms and applying for programs, and much more.

Illinois– Contact AgeOptions at (800) 699-9043 or click the provided link (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Iowa Contact Lifelong Links at (866) 468-7887 or click the provided link (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Minnesota  Contact Senior LinkAge Line at (800) 333-2433 or click the provided link (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Wisconsin (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Consider Mail Order

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Medications may cost less when filled for a three month supply through mail order. See your copayment amounts under the Drug Coverage section to see what you would pay through mail-order. Learn More

Drug Repository Program

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Participating pharmacies can accept donated, unused, sealed medications. These can then be dispensed by a pharmacist to other patients for a minimal charge.

If you would like to donate medications, or find a pharmacy to obtain a donated medication for little or no cost to you, follow the link below to find a participating pharmacy:

Illinois (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Iowa (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Minnesota (By clicking on this link, you will leave the Quartz Medicare Advantage website)

Wisconsin (By clicking on this link, you will leave the Quartz Medicare Advantage website)



Additional Resources

Benefits Checkup is a website run by the National Council on Aging. Visit: Benefitscheckup.org (By clicking on this link, you will leave the Quartz Medicare Advantage website). You can find out if you’re eligible for help with:

  • Medication or health care costs
  • Income assistance
  • Food and nutrition
  • Housing and utilities
  • Employment and volunteering
  • Transportation and more

Medicare Advantage Drug Information

Looking for information on your drug plan? Reach out to a Quartz Champion, or check your formulary (drug list).