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Medicare and Cost Plus Drugs​

A guide on how Medicare works with Cost Plus Drugs.

2023 Medicare & Cost Plus Drugs Cost Comparison Review

CoverRight conducted a review focused on the cost-effectiveness of a series of prescription medications that adults aged 65 and above may encounter.

This review presents nine hypothetical patient profiles, each dealing with different health conditions. The primary objective was to see whether the prescription drugs required to treat these ailments would potentially be more affordable through Cost Plus Drugs than the patient’s Medicare drug plan.

Read our announcement here: Click here

 

Fill out the form below to download the report.

Introduction: Who is CoverRight?

Welcome to CoverRight, we’re a digital health insurance concierge service focused on Medicare. Our mission is to help our customers find the best Medicare plan for their needs while also finding ways to help them save more while in retirement.

As one of our many value adds for our customer, we have collaborated with Mark Cuban Cost Plus Drugs to help Medicare beneficiaries save more.

For more information see our announcement here.

What is Cost Plus Drugs?

Mark Cuban Cost Plus Drug Company offers safe medicines at the lowest possible price. The company provides complete transparency on the cost of drugs so that patients know they are getting a fair price. As a public-benefit corporation, we prioritize our social mission of improving public health.

Cost Plus Drugs’ prices are based on the true cost to get each medication from the manufacturer to you. They cut out the pharmacy middlemen and negotiate directly with manufacturers to get the best possible price. They then show you exactly how much you’ll pay for them to keep their business running and how much it will cost to prepare and ship your prescription.

Why does it matter?

Drug program adherence is a critical component of maintaining health and at CoverRight we want our customers to access all available options to help them achieve this. Working with Cost Plus Drugs means that we can potentially find a less expensive way to help our customers their prescriptions and/or enroll in a less expensive drug plan

We are proud to work with Mark Cuban Cost Plus Drugs to drive a meaningful difference to the U.S. health system for retirees.

Other Relevant Media

Frequently Asked Questions: Cost Plus Drugs & Medicare

As of writing Cost Plus Drugs is a online mail-order delivery pharmacy.   To order prescriptions:

  1. Find your medication in Cost Plus Drug’s online store by searching, browsing alphabetically or by medical condition.
  2. Once you’ve found your medication, sign up for an account.
  3. Reach out to your doctor or provider with Cost Plus Drug’s provided instructions (costplusdrugs.com/contact-your-doctor) to receive your prescriptions.
  4. Once Cost Plus Drug receives a prescription from your doctor, you’ll be notified to checkout.
  5. Your medications will be delivered straight to your door in just a few days.

Cost Plus Drug’s prices are reflective of the true cost to get each medication from the manufacturer to you. We cut out the pharmacy middlemen and negotiate directly with manufacturers to get the best possible price. Then, we show you exactly how much you’ll pay for us to keep our business running and how much it will cost to prepare and ship your prescription.

Currently, the price of drugs listed on Cost Plus Drugs is based on the cost of ingredients and manufacturing plus a 15% margin, $3 pharmacy dispensing fee, and $5 shipping fee.

No – while Cost Plus Drugs provides a great potential alternative to getting your drugs with a standalone Medicare Part D drug plan or Medicare Advantage with Part D coverage included, Cost Plus Drugs does not carry all prescriptions that your Medicare drug plan may cover.

We recommend using Cost Plus Drugs as a supplementary channel to get your prescriptions alongside your Medicare drug plan.

Currently, Cost Plus Drugs does not accept Medicare insurance.  You must order directly from Cost Plus Drugs and pay out of pocket if you intend to use Cost Plus Drugs to fill your prescriptions.

Depending on the prescriptions you are looking to fill, this may still be cheaper than claiming it through a Medicare plan.

Yes, you will still need a Medicare drug plan in order to avoid late enrollment penalties.  Medicare rules require you to have a ‘creditable’ drug plan to avoid being assessed penalties.

Cost Plus Drugs can’t be used in combination with Medicare at the same time, but it can be used in place (or instead) of Medicare when you are purchasing prescriptions.

Because Cost Plus Drugs prescription drug prices may be cheaper than Medicare drug plan copays.  You may want to consider using Cost Plus Drugs instead of Medicare when you purchase certain prescription drugs.

If you choose to use Cost Plus Drugs instead of your Medicare Part D coverage simply purchase the prescriptions that are cheaper through their website directly.

This means that Medicare isn’t involved in the transaction and that you’ll be paying the “cash” price to Cost Plus Drugs directly.

Even if you have Medicare, Cost Plus Drugs can help you save money on your prescriptions, both in the short and long term.  However, because the amount you pay using Cost Plus Drugs coupons will not count toward your Medicare plan, it’s important to think ahead and consider your medication expenses for the full year.

Here’s when to consider using Cost Plus Drugs:

  • When Cost Plus Drugs prices are cheaper than your Medicare copay. While Cost Plus Drugs prices won’t always beat Medicare copays, there are many prescriptions where it may offer a more affordable price.  That’s why it is always worthwhile to check Cost Plus Drugs before going to the pharmacy, especially if you are starting a new prescription or pricing under your plan has changed
  • When you won’t reach your annual deductible. If you don’t foresee a lot of medication expenses and know you won’t meet your deductible for the year, check Cost Plus Drug prices to see if you can save. If you won’t benefit from your plan’s “initial coverage” because you won’t ever pay enough toward your deductible to qualify for it, there’s no point in putting any extra dollars toward it.
  • When you’re in the donut hole. When you’re in the “coverage gap” phase and your Medicare plan is providing less coverage, and typically you will have to pay 25% of the cost of your drugs. Cost Plus Drugs prices may be cheaper than Medicare copays during this coverage gap.

No – currently Cost Plus Drugs is not included with any Medicare Advantage or standalone Part D Prescription Drug Plan. 

At CoverRight, we recommend that you continue to enroll in a Medicare prescription Part D drug plan in order to avoid Medicare late enrollment penalties – even if you are able to find all your drugs on Cost Plus Drugs.

The best way to save on your prescription medications is to compare your options.  At CoverRight, we always recommend that you have Medicare Part D drug coverage in place to ensure that you are not assessed any penalties.

Our licensed advisors will always help to check your drug costs a wide range of Medicare drug plans to ensure you are purchasing your drugs at the lowest possible cost.

They are also available to answer any other questions you may have around Medicare drug coverage.

In addition, with our collaboration with Cost Plus Drugs (as well as GoodRx) we are able to help search across these discounts channels to see if you are able to achieve a better outcome by supplementing your Medicare drug plan with purchases for select drugs on these platforms.

No, Cost Plus Drugs does not have a CMS star rating.

Cost Plus Drugs is not a Medicare Part D drug plan and does not have a contract with the federal government and therefore is not rated by the Centers for Medicare and Medicaid services (CMS).

From a consumer perspective, Cost Plus Drugs and GoodRx both offer an alternate way to purchase your prescriptions outside your Medicare plan.  

At CoverRight, our platform allows you to check your drug prices across both services to see which service could help you save more relative to your Medicare plan.

Cost Plus Drugs is a new service and is one way that you can save on prescriptions.  There are several different types of drug discounts available including GoodRx and Pharmaceutical Assistance Programs (PAPs) where drug companies offer expensive medications at a reduced cost to people in economic need (but perhaps not eligible for Medicaid), although it’s important to note many PAPs are not available to people who are eligible for Medicare.

In order to minimize your drug costs, CoverRight recommends using Cost Plus Drugs as one alternative / supplemental way to reduce your drug costs alongside your own Medicare Part D coverage.

Furthermore, Cost Plus Drugs does not currently carry all drugs covered by Medicare and your Part D prescription drug plan may in many instances still be the lowest cost way to purchase your prescriptions.

Usually yes but this will depend on your Part D plan.  After making a purchase, you may ask your Medicare Part D plan about submitting the receipts toward your annual out-of-pocket (TrOOP) spending records.

Your Medicare Part D plan will not reimburse you for drug purchases made outside of the Medicare Part D plan, but you can ask that the value (what you spent) for the formulary drugs is recorded by your plan.

For more information about submitting your receipts for formulary drug purchased without your Medicare Part D plan, please contact your Medicare Part D plan’s Member Services using the toll-free telephone number found on your Member ID card.