Is There Any Help With Medicare Part D Copays?

Medicare Part D prescription drug coverage provides an added insurance benefit when used along with Medicare's hospital and medical insurance coverage. As with most types of insurance, participants must pay certain out-of-pocket costs, such as copays, in order to benefit from the coverage. In effect, people unable to afford their copay requirements must forfeit the cost savings derived from Part D benefits. Fortunately, there are a few programs available than can help cover copay expenses.

Medicare Part D Copays

• Medicare Part D insurance requires participants to pay an annual deductible and copayments for each drug purchase. Deductible and copayment requirements can change from year to year, according to the Medicare Resource Center. As of 2011, participants must pay a $310 deductible with copays equaling 25 percent of total drug costs for the year. Medicare also has a coverage gap, known as the "doughnut hole," during which participants pay 50 percent of the cost for name brand drugs and 93 percent for generic drugs. The coverage gap period starts once a person uses $2,840 worth of benefits and ends at the $6,447.50 mark. Any medications purchased after the coverage gap within a year's time require a 5 percent copayment amount.

Low Income Subsidy Program

• The Low Income Subsidy Program --- also known as the Extra Help Program --- is a federal assistance program that helps cover Part D cost requirements. Individuals and married couples who fall within a certain income level can qualify for assistance. According to Social Security Online, individuals with resources totaling less than $12,250 or annual incomes less than $16,245 are eligible. Resources considered include stocks, bonds and bank account amounts. Married couples with resources totaling less than $25,010 or incomes less than $21,855 are also eligible. In addition to help with copay requirements, the program may cover premium payments in cases where an individual's or couple's income falls below a certain level.

Prescription Options

• When filling a prescription, Medicare participants have different options as far as the type of drugs prescribed and the number of times they actually fill a prescription, according to Medicare Interactive, a Medicare reference site. In some cases, doctors can prescribe generic brands in place of brand name drugs, which can significantly reduce copay amounts. Doctors can also request that a drug plan administrator allow a particular drug to be placed in a lower cost level or tier in cases where brand name drugs are medically necessary. Another way to reduce copay costs is by using a mail-order option. With mail orders, Medicare participants can fill multiple prescriptions at one time by getting a 60- or 90-day supply, which reduces their overall out-of-pocket cost.

Pharmaceutical & Hospital Programs

• Pharmaceutical companies and hospitals may sponsor programs that offer assistance with Medicare Part D copay costs for people with low incomes, according to Medicare Interactive. Pharmaceutical companies provide low-cost, and in some cases, free medications through Patient Assistance Programs, though not all of these programs accept people with Medicare Part D coverage. Hospitals that have a Charity Care Policy also offer financial assistance towards copay costs. Hospital programs base a person's copayment amounts on a sliding scale, which goes according to a person's income. In some cases, the out-of-pocket costs required by pharmaceutical and hospital programs can count towards Medicare's coverage gap period, provided the pharmacy is part of a person's drug plan network.