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$19 one-time · 25 min read · Lifetime access

Drug Cost Audit Workbook

Find $300-$2,000 of annual prescription savings hiding in plain sight. The 7 strategies most retirees never use, with the exact scripts to use them.

Best for: Anyone on 3+ prescription medications. Most retirees overpay by $400-$1,200/year because they don't know which strategies apply to their specific drugs.

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Who this is for

  • Anyone on 3+ prescriptions
  • People hitting their Part D deductible early in the year
  • People on brand-name medications
  • Anyone whose pharmacy bill keeps surprising them
  • Caregivers managing prescriptions for parents/spouse

What's inside

  • 7-strategy audit framework: tier swap, mail-order, 90-day, generic substitution, manufacturer assistance, pharmacy comparison, GoodRx
  • Drug-by-drug worksheet to track current cost vs. optimized cost
  • Manufacturer patient assistance programs — eligibility + how to apply
  • Insulin and specialty drug optimization (post-IRA $35 cap rules)
  • How to challenge non-formulary denials (formulary exceptions process)
  • $2,100 OOP cap (2026) timing — when to front-load vs. back-load
  • Cheat sheet: 7 strategies, drug-by-drug audit template

Preview — Why drug costs vary so much across plans and pharmacies

The same Eliquis prescription can cost $5/month or $200/month depending on plan, tier, pharmacy, and form factor. This isn't fraud — it's how the prescription drug market is structured. Each plan has its own formulary (covered drug list) and tier structure. Each pharmacy has its own contracted prices with each plan. Mail-order vs retail is a different price entirely. The drug doesn't change. The price you pay does.

Most retirees never audit this. They pick a Part D plan once, fill prescriptions at the same pharmacy out of habit, and pay whatever shows up on the receipt. The 7 strategies in this workbook are the ones that actually move the needle — collectively, they save $300-$2,000/year for typical multi-drug retirees.

8 more sections in the full version

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Full table of contents

  1. Why drug costs vary so much across plans and pharmacies
  2. Strategy 1 — Tier swap (formulary tier optimization)
  3. Strategy 2 — Mail-order (90-day fills via plan-affiliated mail pharmacy)
  4. Strategy 3 — 90-day fills at preferred retail
  5. Strategy 4 — Generic substitution
  6. Strategy 5 — Manufacturer patient assistance programs
  7. Strategy 6 — Pharmacy price comparison + GoodRx
  8. Strategy 7 — Formulary exception requests
  9. Insulin + specialty drug rules (post-IRA)
Key takeaways
  • Same drug = different price across plans, pharmacies, formats. Audit changes things.
  • Mail-order or 90-day preferred retail fills save 25-33% on maintenance drugs.
  • Generic substitution: ask prescriber. 70-90% savings if available.
  • Charitable foundations cover Medicare patients on specific specialty drugs.
  • GoodRx beats Part D for some generics — cash vs insurance comparison.
  • Formulary exception requests work for medically necessary drugs.
  • $2,100 OOP cap (2026) means catastrophic costs are bounded.
Action steps
  1. List every prescription with exact dosage + monthly cost.
  2. Run drug list against all Part D plans in your zip — find lowest-tier-for-each.
  3. For maintenance drugs: switch to mail-order or 90-day preferred retail.
  4. Ask prescriber: 'Is there a generic for this?'
  5. Look up specialty drugs on PAN, HealthWell, Good Days for co-pay assistance.
  6. Check GoodRx prices — use cash for any drug where GoodRx beats Part D copay.
  7. Re-audit every October during AEP.
Cheat sheet — Drug cost audit — 7 strategies + decision tree
  • · 1. Tier swap — different Part D plan = different tier for same drug
  • · 2. Mail-order — 33% off on maintenance drugs
  • · 3. 90-day preferred retail — same savings without the wait
  • · 4. Generic — 70-90% off if available; ask prescriber
  • · 5. Manufacturer assistance — PAN, HealthWell, Good Days for specialty
  • · 6. GoodRx cash — beats Part D for some generics
  • · 7. Formulary exception — for medically necessary drugs not covered
  • · Insulin cap: $35/mo per prescription (IRA)
  • · Part D OOP cap: $2,100 (2026) — once hit, $0 rest of year

FAQ

Why is the same drug different prices across plans?+

Each Part D plan has its own formulary (covered drug list) and tier structure. Pharmacy benefit managers (PBMs) negotiate different prices with manufacturers. Plans pass some savings to enrollees and some to themselves. Net result: different copays for the same drug across plans.

Can I use GoodRx with Medicare?+

You can use GoodRx (cash payment) instead of Medicare for any prescription. But GoodRx payments don't count toward your Part D deductible or OOP max. So GoodRx makes sense when its cash price is lower than your Medicare copay AND you're below the OOP max anyway.

What if my doctor refuses to switch me to a generic?+

If there's no medical reason to require the brand, push back. 'Substitute as written' on a prescription means generic isn't allowed — but most prescribers add this only when truly needed (specific bioavailability concerns, narrow-therapeutic-index drugs). For most maintenance drugs, generic is fine.

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