Do You Even Need a Prescription Drug Plan?

Prescription Drug Plan Discount Programs

So you've enrolled into Medicare and -- by extension -- a Medicare Prescription Drug Plan (Part D).

Over the next few months, each time your fill your prescriptions at the pharmacy, you notice that Discount Programs like GoodRx, SingleCare, or Cost Plus Drugs provide you with lower costs than what your Prescription Drug Plan can provide.

Begging the question:

If I only use GoodRx, do I really need a Medicare Prescription Drug Plan?

After all, you're paying a monthly premium for this plan you don't even use.

The short answer is yes.

Even if you're using discount programs for every prescription you fill, Medicare still expects beneficiaries to maintain creditable prescription coverage if they want to avoid future late enrollment penalties.

The Late Enrollment Penalty (LEP)

For every month that someone goes without creditable prescription drug coverage, they are assessed a penalty (if they are to ever re-enroll into a Medicare Prescription Drug Plan).

The penalty is calculated using:

1% x the national base beneficiary premium ($38.99 in 2026) x the number of uncovered months

The result is then added to your existing monthly Part D premium.

For example, if you go 36 months without creditable coverage, approximately $14 would be added to your monthly premium...for as long as you maintain Medicare drug coverage.

Coverage for High-Cost Prescriptions

Now, you may be saying to yourself:

Why would I ever re-enroll in a Medicare Part D Plan? I'll just keep using GoodRx.

While this method does get rid of the penalty problem, it puts you in an extremely vulnerable position.

Discount Programs can be excellent tools, but they often fall short when it comes to high-cost, brand name medications. Some of these medications can cost hundreds or even thousands of dollars per month. A discount card might reduce the price, but there is no built-in safety net preventing expenses from continuing indefinitely.

Beginning in 2026, Medicare prescription drug coverage includes a $2,100 annual out-of-pocket cap for covered Part D medications. Once that threshold is reached, beneficiaries pay $0 for covered prescriptions for the remainder of the calendar year. 

Use Discount Programs Strategically

GoodRx can be helpful, but it wasn't designed to replace your Medicare Prescription Drug Coverage.

In many situations, the question isn't "Which one should I use?" It's "How do I use both strategically?"

That is often where guidance becomes valuable. At Seniority Benefit Group, we help clients evaluate medications, compare plan options, and determine which cost-saving approaches make the most sense for both today's expenses and long-term financial protection.

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