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Medicare: Your GoodRx guide
Learn the ins and outs of Medicare with our comprehensive guide that covers eligibility, coverage, costs, and more.
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Common Medicare glossary terms
The Medicare Annual Notice of Change (ANOC) is a letter for people enrolled in Medicare Advantage plans and anyone with Medicare Part D prescription coverage. People with Medicare Advantage or original Medicare (Part A and/or Part B) can have Part D plans. The ANOC informs enrollees about any changes to their benefits for the coming coverage year. By law, Medicare Advantage and Part D plans must send the ANOC to enrollees by September 30 — which is before the annual Medicare open enrollment period of October 15 to December 7. Even if you have the same plan, your benefits could change year to year.
A premium is the cost of having a health insurance plan and is usually paid monthly. Medicare enrollees may pay several premiums. Most people don’t pay anything for Part A hospital insurance, but some people do depending on how long they worked and paid taxes. For outpatient and preventive coverage, the Part B standard premium is $185 a month in 2025, but people with higher incomes pay more. Your premium for Medicare Advantage plans will vary, but even so-called “zero premium” plans require you to pay your Part B premium. Part D premiums range in price, but the average is about $47 a month in 2025. If you have original Medicare and a Medigap supplement plan, you have an additional premium for that coverage.
A deductible is the amount you pay out of pocket before your Medicare plan begins cost-sharing. In 2025, the Part A deductible is $1,676 per benefit period. The Part B deductible is $257 for the year, but you can access certain preventive care — including some vaccines — without meeting your deductible. Medicare Advantage deductibles vary and your Part D deductible can’t exceed $590 in 2025.
Original Medicare has no annual out-of-pocket maximum. Medicare Advantage plans have out-of-pocket limits. In 2025, they are $9,350 for in-network covered services and $14,000 for in-network and out-of-network covered services combined.
Starting January 1, 2025, anyone with Part D coverage had the option to use the Medicare Prescription Payment Plan for their out-of-pocket medication costs instead of paying upfront at the pharmacy. This plan doesn’t provide savings, but allows you to spread prescription costs — including your deductible — over the year. Making payments can be particularly helpful for people who may skip or delay picking up prescriptions because of high costs early in the year. Also in 2025, the Part D out-of-pocket limit dropped to $2,000.
After a Medicare enrollee meets the Part D deductible (if the plan has one), the health insurance begins cost sharing. The initial coverage phase means you pay coinsurance or a copay for covered prescriptions.
When you reach the $2,000 out-of-pocket maximum, your Part D plan pays for 100% of covered medications for the rest of the year.
How to save on drugs with Medicare
Medicare Part D is the part of Medicare that helps cover prescription medications, including both brand name and generic. It also includes coverage for certain vaccines that aren’t covered by Part B, as well as some medical supplies.
Even with Medicare Part D coverage, you may still have out-of-pocket costs such as premiums, deductibles, copayments, and coinsurance. As of 2025, Medicare Part D plans include a $2,000 annual out-of-pocket cap. Once you reach this limit, your plan covers the full cost of your covered medications for the rest of the year.
Still, there are several ways to reduce your prescription medication cost. From GoodRx coupons to patient assistance programs, here are ways you can save money on the medications you need.
1. See if you qualify for Medicare’s Extra Help program
The Medicare Extra Help/Low-Income Subsidy program is a federally funded program for people covered under a Medicare Part D plan. It helps reduce enrollees’ out-of-pocket costs by limiting their deductibles and copays. To qualify, your income and assets fall below a certain limit.
If you’re eligible, you may receive:
No monthly premiums for Medicare Part D
No Medicare Part D deductible
Low copays for prescription medications
2. Use GoodRx coupons
You can’t combine GoodRx coupons with Medicare, but you can choose to use a coupon instead of your insurance if it results in a lower price.
Here’s how to download a GoodRx coupon:
Go to the GoodRx website, or download the GoodRx app on your phone.
Search for your prescription medication.
Enter your prescribed dose and quantity, then set your location.
Compare prices across different pharmacies in your area.
Click “Find the lowest prices” or press “Enter.”
You can have the coupon sent by text or email, or print it out.
To apply the discount, show the coupon at the pharmacy when you fill your prescription. Ideally, this is done at drop-off before the prescription is filled.
3. Consider the Medicare Prescription Payment Plan
The Medicare Prescription Payment Plan is a new program that can help make paying for medications more manageable. It’s open to anyone with a standalone Part D plan or those with Medicare Advantage plans that offer prescription medication coverage.
There is no cost to participate in the Medicare Prescription Payment Plan and participation is voluntary. Instead of paying for the total cost of your medications up front at the pharmacy, the payment plan allows you to spread the cost into smaller payments during the year. If you join, you will continue to pay your premium every month as well as an additional monthly amount on your payment plan. It’s a good idea to review how the Medicare Prescription Payment Plan works to determine if it’s right for you.
4. Compare Part D plans during open enrollment
Medicare open enrollment, which takes place every year from October 15 to December 7, is your chance to switch plans if another option offers better prescription medication coverage or lower costs. Plan costs and coverage details can change each year, so it’s important to review your options.
Here are some steps to help you compare plans:
Make a list of all your medications and what dosages you take.
Visit Medicare’s plan finder tool.
Enter the names of your prescription medications to see which plans offer the best coverage.
Look at premiums, deductibles, and medication costs for each plan. Plans usually change their formularies, premiums, and copays annually.
Check if your preferred pharmacy is in each plan's network.
5. Get a 90-day supply
Opting for a 90-day supply instead of a monthly refill of your medication might help reduce your long-term out-of-pocket costs. Many insurance plans offer lower copays or bulk pricing for 3-month prescriptions.
If your medication is covered under your plan, see if your insurer’s mail-order or specialty pharmacy provides savings on a 90-day supply. If they do, ask your prescriber to write a prescription for a 90-day quantity to take advantage of these potential savings.
6. Ask about the generic version of your medication
Some medications have a generic version, and they generally cost less than the brand-name prescriptions. Generic medications are just as safe and effective as brand-name medications, so it’s an option worth considering to reduce your cost. Ask your prescriber about switching to a generic version of your medication to save money.
7. Consider lower-cost alternative medications
There may be other medications that help manage your condition, and they may cost less. If your medication is costly or not covered by your insurance, talk to your prescriber about lower-cost alternatives that might be a good option for you. Alternatives might have better insurance coverage or lower costs.
8. Learn more about patient assistance programs
Patient assistance programs (PAPs) offer free or low-cost medications to uninsured and low-income consumers. These programs, which primarily offer savings on brand-name medications, are usually run by private pharmaceutical companies or nonprofit organizations. You must meet certain qualifications and complete paperwork to receive savings from PAPs. However, some PAPs exclude Medicare recipients, so it’s important to review the program’s rules and requirements carefully.
9. Check state-funded resources
Depending on where you live, your state may offer programs to help you navigate prescription medication costs. A good place to start is your local Department of Aging. This U.S. Department of Health and Human Services office can help you find the best Medicare plan for the coverage you need.
Some states even have their own cost-saving programs for older adults. For example, Pennsylvania runs PACE and PACENET. These programs help eligible residents get prescription medications at reduced costs.
Alternatively, you can find out if your state has a State Pharmaceutical Assistance Program by using Medicare’s search tool. These programs are state-run and help qualifying residents pay for prescription medications.
10. Use a health savings account to pay for prescription medications
Although you can’t contribute to a health savings account (HSA) after enrolling in Medicare, you can still use any remaining funds in your account to pay for qualified medical expenses. An HSA allows you to use tax-free dollars to pay for eligible prescription medications. The money in your account does not expire so you can use your funds at any time to reduce your out-of-pocket medication costs.
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Frequently asked questions about Xhance
Your healthcare team will show you how to use Xhance if you're starting treatment for the first time. The Xhance device is different from that of typical nasal sprays. Instead of pressing down on a spray pump to release a spray and breathing in to take the dose, Xhance has a mouthpiece that you place in your mouth and a nosepiece that you place in your nostril. To use Xhance nasal spray, you first blow into the mouthpiece like a balloon. As you continue to blow, you press the bottom of the Xhance bottle with your thumb to release the medication. Your breath helps the medication travel far up the nasal passage; you don't need to inhale or sniff as the medication is released. If you have any questions about how to use Xhance, contact your prescriber or pharmacist.
Xhance should start to work to improve stuffy nose within 2 weeks after you start taking it. Talk to your prescriber if you haven't noticed an improvement in your symptoms after 2 weeks. They might need to adjust your dose or switch you to a different treatment.
In clinical studies of people with nasal polyps (NP) and without NP, those who took Xhance reported more improvement in their nasal congestion symptoms after 4 weeks of treatment compared to those who took a placebo (no active medication). People in both groups also noted an improvement in other symptoms related to chronic rhinosinusitis, such as lessening of facial pain and pressure. Talk with your healthcare team if you have more questions about how well Xhance works.
Based on available research, Xhance has been shown to be well-tolerated for up to a year of treatment. More studies are needed to help us understand how Xhance might affect the body with long-term use. When you start treatment, ask your prescriber about how long they want you to take it. Keep in mind that Xhance doesn't affect everyone the same way, so the time it takes for your symptoms to get better can vary depending on how your body responds to the medication.
Xhance isn't an antihistamine. It belongs to a group of medications called corticosteroids, or steroids for short.
Flonase (fluticasone) and Xhance are nasal sprays that contain the same active ingredient (fluticasone). But they're not the same. One difference is what medical condition they're able to treat. Flonase only treats allergy symptoms, but Xhance is FDA-approved to treat chronic rhinosinusitis with or without nasal polyps. Another difference is how they're used. Flonase comes in a more traditional nasal spray bottle that contains a nosepiece. You take Flonase by pressing down on the spray pump and breathing in as the medical comes out. On the other hand, Xhance has both a nosepiece and a mouthpiece –– it uses the power of your breath through the mouthpiece to help deliver medication high and deep inside your nose. The two medications shouldn't be swapped for one another. If you have questions about which medication is right for your symptoms, speak with your primary care provider.
Each 16 mL bottle of Xhance contains 120 sprays after the initial priming. Keep in mind that each time you need to prime it (after you haven't used the bottle for a week or longer), you'll use some of these sprays. Keep track of each time you use Xhance because you'll need to throw it away and get a new bottle after you use 120 sprays.
