COLORADO SPRINGS, Colo. (KOAA) — Some Medicare beneficiaries could soon pay significantly less for popular GLP-1 medications under a new federal pilot program, while pharmacists say many other patients may also be spending more than necessary on the drugs. Click here to see if you're eligible.
Beginning July 1, the Centers for Medicare & Medicaid Services launched a bridge program designed to help eligible Medicare Part D beneficiaries afford certain GLP-1 medications, which are commonly prescribed for weight loss and diabetes but can cost hundreds or even thousands of dollars per month.
"It's a bit of a trial basis to help provide a little bit of a gap or a bridge coverage for these folks on Medicare with Part D coverage," said Cameron Phillips, wellness coordinator for King Soopers. "Because, as I'm sure you've heard, they can be quite expensive."
Phillips said eligible Medicare Part D beneficiaries may now be able to receive covered GLP-1 medications for as little as a $50 copay.
Beyond the new Medicare program, Phillips said many patients with commercial insurance or other coverage may also be paying more than they need to because they do not explore available discounts or alternative medications.
"This whole process is really pretty complex and complicated," Phillips added. "A lot of times, when people come into the pharmacy, they see the original GLP-1 price that gets sent over from their doctor, and they're shocked because it's so expensive. But the price that you see is not always the price that you need to be paying because there are a lot of different options to help get that cost down."
Pharmacists can help patients determine whether another medication is covered by insurance, identify manufacturer coupons or apply discount cards that could substantially reduce out-of-pocket costs.
"We have access to a number of different resources to help get that price down," Phillips explained. "We can change it to a different prescription that is covered through your insurance. We can check out some discount cards and we can also get access to some manufacturer coupons."
Phillips encouraged patients who receive a high pharmacy bill not to assume they have exhausted their options.
"There's no risk to at least look at it and explore your options," he said. "If another option that is covered by your insurance is a good alternative, then we can reach out to the doctor, we can change that product... and we can drastically reduce that cost."
While Phillips said he could not estimate how many customers are overpaying, he believes it is common.
"I'd say there's a good portion of folks that are overpaying and they don't realize it because, again, they just haven't taken the time to reach out to us and to utilize our services," he said.
He said pharmacists remain an important resource for patients trying to navigate the often-confusing cost of prescription medications.
"We are always trying to get folks the best price on their medications and to really just take care of them from an overall perspective," Phillips said. "Price can be very prohibitive when we're talking about these kinds of medications, and we're a really good resource to help reduce those costs and to get people the medications they need."
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
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