10 Ways to Lower Your Prescription Drug Costs
Whether you’re likely to reach the Coverage Gap this year or simply trying to save money, you can explore these 10 options help lower your prescription drug costs.
1. Use Home Delivery and Save Up to $212 on Prescription Drug Costs
With OptumRx Home Delivery Pharmacy, plan members can avoid going to the pharmacy by having the prescriptions you take regularly conveniently mailed to your home. You may be able to save money on a 90-day supply of prescription medications (depending on the plan you are in and the tier your drug is on).
See the chart below for what you may be able to save. Plan members can sign up by visiting OptumRx.com, or call OptumRx at 1-800-299-7648 (HMO)/1-800-460-0322 (PPO).
HMO Smart Saver Rx | HMO Saver Rx, Basic Rx, and Value Rx | HMO Prime Rx | HMO Prime Rx Plus | PPO Access |
Save $53 on a 90-day supply | Save $49 on a 90-day supply | Save $45 on a 90-day supply | Save $30 on a 90-day supply | Save $49 on a 90-day supply |
2. Use Preferred Pharmacies
If your plan includes prescription drug coverage, you can save money by using a preferred pharmacy:
Plan | Tier | Cost using a non-preferred pharmacy (30-day supply) | Cost using a preferred pharmacy (30-day supply) |
HMO Smart Saver Rx | Tier 1 Drugs | $14 | $0 |
Tier 2 Drugs | $19 | $2 | |
HMO Basic Rx HMO Saver Rx HMO Value Rx Access PPO | Tier 1 Drugs | $14 | $0 |
Tier 2 Drugs | $19 | $4 |
There are more than 600 preferred pharmacy locations in our Massachusetts network, including national chains such as CVS Pharmacy®, Stop & Shop, and Walmart. Starting January 1, 2024, Costco and Wegmans will also be preferred pharmacies.
To find a preferred pharmacy near you, HMO members can visit thpmp.org/hmo-pharmacies and PPO members can visit thpmp.org/ppo-pharmacies. To transfer a prescription to a preferred pharmacy, simply call the preferred pharmacy of your choice and ask them to transfer your prescription.
3. Connect With Us for Help
If you’re a plan member and you have questions about your drug coverage, need help managing your medications, or would like assistance with lowering your prescription drug costs, we can help. Call Member Services at 1-800-701-9000 (HMO)/1-866-623-0172 (PPO) (TTY: 711). Representatives are available 8:00 a.m.–8:00 p.m., 7 days a week (Mon.–Fri. from Apr. 1–Sept. 30).
4. Use Generic Drugs
Generic drugs generally cost less than brand name drugs and have the same active-ingredient formula as brand name drugs. In addition, generics are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Talk to your doctor to see if generic drugs are right for you.
5. Call Prescription Advantage
Prescription Advantage is a program that helps Massachusetts seniors with the cost of Part D prescription drugs. They offer a variety of assistance depending on income. Call 1-800-AGE-INFO (1-800-243-4636) (TTY: 1-877-610-0241). Customer Service representatives are available to answer your questions Mon.–Fri., 9:00 a.m.–5:00 p.m. Or visit prescriptionadvantagema.org.
6. Contact My Advocate for Help Applying for Assistance
My Advocate can assist Tufts Health Plan Medicare Advantage members with applying for Extra Help (see below) and Medicare Savings Programs. For information, call 1-844-247-0985. Representatives are available Mon.–Fri. 9:00 a.m.–6:00 p.m. Or visit myadvocatehelps.com.
7. See if You Qualify for Extra Help, Also Known as the Low Income Subsidy (LIS)
LIS is a federally funded program that assists with monthly premiums and Part D prescription copays for those who meet certain financial requirements. For information, call My Advocate at 1-844-247-0985 or the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778). Or visit ssa.gov/medicare/part-d-extra-help.
8. Use the Pharmacy Outreach Program
The Pharmacy Outreach Program is a free service of the Massachusetts College of Pharmacy and Health Sciences. It offers advice about prescription assistance programs, medication counseling, and more. For information, call 1-866-633-1617. Representatives are available Mon.–Fri., 8:30 a.m.–5:00 p.m. You can also visit mcphs.edu/patient-centers/pharmacy-outreach-program for more information.
9. Visit Needymeds.org
Needymeds.org is a website that allows you to search a drug by name or category (i.e., brand or generic), to find out if there is a prescription assistance program available for that particular medication. For information, email info@needymeds.org, call 1-800-503-6897, or visit needymeds.org.
10. Look into Assistance Offered by Drug Manufacturers
You may qualify for help with the cost of certain medications through prescription assistance programs offered by the drug manufacturer. Every drug manufacturer has certain criteria that you must meet to qualify for help.
For assistance, plan members can call Member Services at 1-800-701-9000 (HMO)/1-866-623-0172 (PPO) (TTY: 711). Representatives are available 8:00 a.m.–8:00 p.m., 7 days a week (Mon.–Fri. from Apr. 1–Sept. 30).