Medicare and Rising Prescription Drug Costs

Know your prescription cost and options
he passing of the Inflation Reduction Act of 2022 has, among other things, introduced reforms that will help lower prescription medication prices. For seniors taking multiple medications, this can be life changing; the skyrocketing cost of medications led to many people not picking up their medications from the pharmacy – or even splitting their doses in half to avoid running out of their medications.1 Not taking routine medications or the proper dosage of a prescribed medication can result in health conditions not being properly managed, which can lead to more doctor visits or a hospital stay.
Become a more informed health care consumer
Another tool at your fingertips
When you log in to your Blue Shield account on your computer and go to the Pharmacy page, or you log in to the Blue Shield app on your smart phone, you can choose to price check your current prescriptions and:
- See your active prescriptions and their current costs.
- See lower-cost alternative options (generic and brand alternatives) and potential savings specific to you (if available).
- See how much you would pay if you filled your prescription at a different pharmacy. (Coming April 2023)
- Estimate prescription costs to see if you will reach the Part D coverage gap before the end of the year, and to look for alternatives to avoid reaching the coverage gap.
- Call your doctor’s office to ask about a new prescription for a lower cost alternative medication. Your doctor may want to schedule time to discuss it with you first before ordering a new prescription.
- Call the new pharmacy and ask to have your current prescription transferred. You will need your current pharmacy’s name and phone number, and your prescription number. If your prescription does not have refills or needs to be renewed, the pharmacy may ask you to contact your doctor first.
- Call Blue Shield Customer Care using the phone number on the back of your member ID card. Our representatives are ready to assist to talk with your doctor and can refer to one of our pharmacy specialists for extra assistance.
How generic medications impact your costs
Wat you should know about generic medications:
- New brand-name drugs are protected by U.S. patents to prevent other manufacturers from selling generic versions of the same medication. Generally, after the patent has expired, manufacturers can make and sell generic versions of that medication to compete with the original brand-name medication.
- Many generics cost 80% to 85% less than brand-name medications.2 Generic medications cost less because manufacturers do not have to spend as much on research and marketing of the generics. If you’re taking a brand-name medication, talk with your doctor to see if there is a generic alternative that would be right for you.
- They are safe and effective. Generic medicines that are approved by the U.S. Food and Drug Administration (FDA) have the same active ingredients and work the same way as brand-name medicines. The FDA’s Generic Drugs Program conducts a thorough review to ensure that generic medicines have the same health benefits and risks as brand-name medicines.
Other brand medications that can lower your costs
- Brand alternatives must meet the same FDA requirements for safety and effectiveness.
- These medications may have an advantage over the original brand-name medication such as fewer side effects, formulations that are easier to take, less frequent dosing, and in some cases, better health outcomes.
- Through competition, brand alternatives in the same category help lower the cost of medications for all.