A Look at Brand Name vs. Generic Drugs under Medicare Part D

All 54 million people on Medicare, including those ages 65 and older and those under age 65 with permanent disabilities, have access to the Medicare drug benefit available through private plans approved by the federal government. Individuals can get drug coverage through a stand-alone Medicare Prescription Drug plan or a Medicare Advantage Prescription Drug plan.

Medicare beneficiaries who take a generic drug instead of a brand-name medication could save hundreds of dollars in drug costs. In fact, in the last decade the generic drug industry has saved consumers and payers over $1.2 trillion in prescription drugs.

Why are brand names more expensive? Generic drugs are typically 40% of the cost of their brand counterparts. Brand-name drugs are generally more expensive because of the higher initial costs to develop, market, and sell a brand-new drug.

But not everyone is able to take generic alternative, as it may not be available or it may be medically necessary to take the brand-name drug. Speaking with a doctor about what medications would work best for your condition and if there is a generic alternative is recommended. Also, be sure to always talk with your provider before beginning a new medication or switching drugs.

If you need to take a brand-name drug, you may have to pay higher out-of-pocket costs, depending on your drug plan’s payment structure. Medicare prescription drug plans often place drugs into different payment “tiers” with different costs for each tier. Higher tiers usually have higher copayment and/or coinsurance costs, and every prescription drug plan categorizes its covered drugs differently.

Omaha Insurance Specialists can look at the plans with you and see how they treat brand names vs. generic drugs so that you have a clear understanding of what it will mean if you need to take a specific brand-name drug. The plan that’s right for you will depend on which prescription drugs you take and the cost structure involved.

Everyone Is Unique.

The right Medicare plan is the one with which you’re most comfortable. We’ll help you make this important choice by reviewing all the details of each plan with you. To speak with a licensed independent agent, give us a call at Omaha Insurance Solutions at 402-614-3389 TTY 711.