Why can’t Medicare patients use coupons?

Medicare is an amazing program put into place to serve the elderly and people regarding their healthcare requirements. People who are under the umbrella of the Medicare program spend a lot of money on prescription drugs. Many senior citizens being on fixed incomes are looking for ways to save money while buying drugs and using coupons to save some.

However, the use of coupons is not allowed for all cases. In this article, we will explain more about them.

Medicare prohibiting the use of coupons

Unfortunately, Medicare prohibits the use of any coupons or discount packages by the patients to retrieve drugs. This is because of the Federal anti-kickback law, which demonstrates that it is illegal for drug manufacturers to offer or contemplate any type of discount offering or the use of saving coupons regarding the Medicare program patients.

These companies can’t persuade patients that are covered by this program to purchase something that federal healthcare programs such as Medicare or Medicaid pay for, hence the restriction to use any type of coupons.

What is the Anti-kickback Statute?

The Anti-kickback Statute was put into place to cover the healthcare industry’s fraud and abuse. This made it impossible for the medical companies to give anything of value as an advertising stunt or exchange for a consumer coupon reimbursed by federal healthcare programs such as Medicare and Medicaid. 

The action of providing the Medicare beneficiaries (people who are dependent on the program) with any type of coupons or advertisement code that can help them buy drugs or other items from the medical company is registered as a crime. 

When can you use drug coupons?

The federal government imposes certain conditions to oversee that cheating doesn’t take place and that the Medicare program can be as efficient as possible. Therefore, you can’t use both the drug discount coupon and your Medicare prescription drug plan. But you can use a Drug discount coupon if you don’t use the Medicare prescription drug plan.

You can’t choose to go with both options at a single time because it will be in clear violation of the Anti-kickback program if you do. 

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Will it help if you buy medicine with a coupon?

There are different medicine tiers within the Medicare program in which different medicine classes are being recorded and assigned different prices. There are a total of 4 tiers covering different types of prices for these medicines.

If you are enrolled in the Medicare program, you will receive the exact cost of the drug you will buy. This information is freely available, backed up by laws such as the “Know the Lowest Price Act” of 2018 and the “Patient Right to Know Drug Prices Act” of 2017. 

Therefore if you ever come around with the information that your medication is cheaper with the coupon or discount than with your Medicare program, then you are at liberty to buy that medicine using the variable coupon code.

But this way, you will have to let go of your Medicare prescription. Hence you can tell the pharmacist to charge you out of your pocket for that drug.