Coupons & Copay Cards: What Are They and How Do They Benefit Patients?

Navigating the cost of prescription medications can be overwhelming. Thankfully, drug manufacturers offer tools like coupons and copay cards to help ease the financial burden—especially for those with commercial insurance. Here's what you need to know:

💳 Coupons

What they are: Manufacturer discounts that reduce out-of-pocket costs, typically for brand-name medications.
Who benefits: Mostly patients with commercial insurance.
How they help: Coupons lower your pharmacy cost at the register, making necessary medications more affordable.

💸 Copay Cards

What they are: Cards that limit the amount you pay for a prescription at the pharmacy.
Who qualifies: Patients with commercial insurance.
Who doesn’t qualify: Medicare, Medicaid, and Tricare patients are not eligible due to the Federal Anti-Kickback Statute.

🛑 Why the restriction? This law prevents drug companies from offering financial incentives (like copay cards or coupons) to patients on government insurance, which could influence prescription choices that aren't necessarily in the patient's best interest.

📌 For Medicare Patients

While copay cards aren't allowed for Medicare patients, there are still resources available:

Prescription Assistance Programs – Often offered by non-profits or manufacturers.
Tiered Formularies – Medicare plans may cover alternative medications at lower costs.
Talk to your doctor – They can help explore cost-effective alternatives.
Call your plan's Member Services – The number is on the back of your insurance card!

🩺 The Bottom Line

If your medication is too expensive, don’t stop taking it. Help is available! Always speak with your doctor or contact your insurance provider for assistance options.

Who can I contact for more help?

Shelly Davis, LPN

Prescription Assistance Case Manager

Northeast Missouri Health Council Administration Building

1416 Crown Drive, Kirksville, MO 63501

Phone: 660-627-5757, ext. 1021