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Manufacturers’ Coupons and Medicare

Mar 11, 2016

Depositphotos_54389541_s-2015.jpgI tried to use a $25 coupon to pay for a very expensive brand-name medication. My pharmacist said I couldn’t use it because I am on Medicare. Why is this? How come I can’t save money just like younger folks?

Manufacturers issue coupons to lure consumers into purchasing a particular coffee. In the grocery store, we can save on cereal, coffee, soup, all kinds of food items. However, for those with Medicare, things change.

When it comes to medications, a coupon can entice a Medicare beneficiary to purchase medication A, instead of medication B. When the products involved are part of a Federal program, such as Part D medications, the anti-kickback statute comes into play. This statute makes “it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward the referral or generation of business reimbursable by any Federal health care program.” In other words, using a coupon to purchase a Part D medication would constitute a fraudulent claim until Federal law.

This same stipulation applies to drug discount programs. The beneficiary pays a fee and gets discounts on selected medications. 

Also know that younger folks, such as those who are on Medicaid, another federal program, can’t use coupons for medications. This same rational applies to discount programs, such as a medication savings card. 

Beneficiaries always have the option to purchase medications outside of the Part D prescription drug plan. If there is a valuable coupon or discount, tell the pharmacist that you want to pay for this drug and not to process it through the insurance. 


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