🏠 Home → Medicare Gap Help

Medicare Gap Coverage & High Copay Assistance

You Deserve Better

Medicare coverage gaps and high copays shouldn't prevent you from getting essential medications. Find assistance programs designed specifically for Medicare patients facing financial hardship.

🤗We Understand Your Medicare Challenges

You've paid into Medicare your whole working life, and you deserve comprehensive coverage. When Medicare falls short with coverage gaps, high copays, or excluded medications, assistance programs exist to fill those gaps. Your health shouldn't suffer because of Medicare's limitations.

💡The Truth About Medicare and Prescription Costs

Many Medicare patients face unexpected high costs due to the "donut hole," non-covered medications, or high-tier copays. Manufacturer assistance programs often work WITH Medicare to reduce your out-of-pocket costs, even if you have coverage. Having Medicare doesn't disqualify you from additional help.

🕳️ Medicare "Donut Hole" Gap
High Impact

The Medicare Part D coverage gap (donut hole) can leave you paying full price for medications after reaching the initial coverage limit, often around $5,030 in total drug costs.

In the donut hole: 25% of brand-name drug costs
With assistance: $0-$25/month
  • Manufacturer Copay Cards
    Many work alongside Medicare to reduce your portion of the cost during the donut hole period.
    Search by medication name
  • Extra Help (Low Income Subsidy)
    Medicare program that helps with prescription drug costs if you have limited income and resources.
    1-800-MEDICARE
❌ Non-Covered Medications
Full Cost

Some medications aren't covered by Medicare at all, leaving you to pay the full retail price. This often includes newer medications, certain specialty drugs, or medications not on your plan's formulary.

Without Medicare coverage: $500-$5,000+/month
With assistance: $0-$50/month
  • Manufacturer Patient Assistance
    Direct assistance from drug companies for non-covered medications, often providing them for free.
    Contact manufacturer directly
  • Medicare Appeals Process
    Request coverage determination or appeal non-coverage decisions with your doctor's support.
    Contact your Medicare plan
💰 High Tier Copays
Ongoing Cost

Specialty medications on higher tiers can have copays of $100-$500+ per month, even with Medicare coverage. These ongoing costs can strain fixed incomes.

Medicare copay: $100-$500/month
With assistance: $0-$25/month
  • Copay Assistance Programs
    Manufacturer programs that work with Medicare to reduce your copay portion to a manageable amount.
    Search our database
  • State Pharmaceutical Assistance
    Some states offer additional prescription assistance for Medicare beneficiaries.
    Check your state's program
🧬 Specialty Medications
Complex Coverage

Specialty medications for conditions like cancer, rheumatoid arthritis, or rare diseases often have complex coverage rules and high out-of-pocket costs even with Medicare.

Specialty drug costs: $1,000-$10,000+/month
With assistance: $0-$50/month
  • Specialty Drug Assistance
    Comprehensive programs for specialty medications that often provide extensive financial assistance.
    Contact specialty pharmacy
  • Foundation Assistance
    Disease-specific foundations that help Medicare patients with specialty medication costs.
    Search by condition

🌟Special Programs for Medicare Patients

These programs are specifically designed to work with Medicare and help with additional costs:

💊 Medicare Extra Help

Official Medicare program that helps with prescription drug costs for those with limited income and resources.

1-800-MEDICARE (1-800-633-4227)

🏥 Medicare Supplement Insurance

Medigap policies that can help cover some prescription costs not covered by original Medicare.

Contact insurance providers

🏛️ State Pharmaceutical Assistance Programs

State programs that provide additional prescription assistance specifically for Medicare beneficiaries.

Contact your state health department

🤝 Medicare Advantage Plans

Some Medicare Advantage plans offer enhanced prescription drug coverage or supplemental benefits.

Compare plans during open enrollment

💪 Real Medicare Patient Success Stories

These Medicare patients found assistance programs that work alongside their Medicare coverage:

"I hit the Medicare donut hole and my diabetes medications went from $40 to $300 a month. Through Script Saver, I found manufacturer programs that cover my costs even during the donut hole. Now I pay $10 a month year-round."
💜 Eleanor R., Medicare Beneficiary
Saves $290/month in donut hole
"My cancer medication wasn't covered by Medicare and cost $8,000 a month. The manufacturer assistance program provides it for free, and it works alongside my Medicare coverage for my other medications."
💙 Frank M., Cancer Patient
Saves $8,000/month • Free cancer medication
"My Medicare plan had a $400 copay for my heart medication. I thought that was just what I had to pay. The copay assistance program reduced it to $5 a month, and Medicare still covers the rest."
💚 Dorothy K., Heart Patient
Saves $395/month • Works with Medicare

🚀 Your Medicare Assistance Pathway

Getting additional help with Medicare prescription costs is straightforward and often works seamlessly with your existing coverage:

1
Review Your Medicare Costs

Identify medications with high copays, those not covered, or costs during the donut hole period.

2
Search Assistance Programs

Find manufacturer programs and copay assistance that work alongside Medicare for your specific medications.

3
Apply for Multiple Programs

You can receive help from manufacturer programs, foundations, and state programs simultaneously with Medicare.

4
Coordinate with Medicare

Most assistance programs work seamlessly with Medicare, often reducing your portion to $0-$25/month.

🎯 Reduce Your Medicare Prescription Costs Today

Don't let Medicare gaps or high copays prevent you from getting essential medications. Find assistance programs that work with your Medicare coverage to reduce your out-of-pocket costs.

🔍 Find Assistance for My Medicare Medications 📚 More Medicare Resources