If you’ve ever stood at the pharmacy counter, wondering why your Medicare Part D plan is charging more than what you saw online with a discount card like GoodRx, you’re not alone. As a licensed Medicare agent who’s helped hundreds of people through this maze, I get this question more than almost any other.
So let’s clear it up: You can use a drug coupon or discount card instead of your Medicare Part D benefits — but you can’t use both at the same time.
Let me give you a real-life example. One of my clients, Brenda, takes a generic thyroid medication every month. Her Part D plan had it listed for $18. But when she checked GoodRx, the same prescription was just $9 at her local pharmacy. She was surprised — and a little frustrated — because she assumed her Medicare plan would always be cheaper.
The reason you can’t combine them is because of a federal law called the Anti-Kickback Statute. It’s there to prevent fraud and abuse in federal programs like Medicare. So if a manufacturer gives a coupon or copay assistance to someone enrolled in Medicare, it’s considered an illegal inducement.
The bottom line: You have to choose — either use your Medicare Part D coverage or use the discount card.
You can use a discount card or coupon if:
But here’s the catch: If you skip your Medicare card and pay cash with a coupon, it won’t count toward your Part D deductible or out-of-pocket maximum. That might not matter for a $9 prescription, but it could impact your costs if you're managing multiple medications.
When you fill a prescription, try this simple phrase:
"Can you please check if this is cheaper with my Medicare Part D plan or with this discount card?"
Most pharmacists will gladly help — though it may vary by pharmacy chain. I always recommend checking with a preferred pharmacy in your plan network first. They often have lower negotiated rates than out-of-network or retail cash prices.
Some clients ask, “If I can get most of my meds cheaper with a coupon, do I even need Part D?”
That’s a risky move.
Even if you don’t take expensive medications now, you could face a permanent late enrollment penalty if you don’t enroll in Part D when you’re first eligible. You can estimate yours with our free Medicare Part D Penalty Calculator.
Think of Part D like car insurance — it’s there for the big stuff, even if you don’t use it every day.
Besides using discount cards, here are a few tips that have helped my clients save money without giving up their Medicare benefits:
And starting in 2025, there’s even better news: Medicare Part D will have a $2,000 out-of-pocket cap — thanks to the Inflation Reduction Act. This change alone could make it more affordable to stick with your Medicare plan rather than paying cash with a coupon.
Bottom line? Prescription discount cards can be a great tool — especially for occasional savings on generics. But they’re not a replacement for Medicare. Use them wisely, and when in doubt, talk with someone who understands the ins and outs.
If you ever want a quick review of your plan’s drug pricing or want help comparing options, I’m happy to help.
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