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Help Paying for Prescriptions: Your 2026 Guide to the Lowest Legal Cost

Simple steps to pay less for medicine and health care: Medicare, Medicaid, insurance, HSAs, cash prices, and every government program that can help.

Last updated October 29, 2026 · By the eDrugSearch team · Facts checked against Medicare.gov, CMS, Social Security, the IRS, HealthCare.gov, Medicaid.gov, HRSA, the FDA and U.S. Customs

Cheat Sheet: 10 fastest ways to save

  1. Ask for the cash price and your insurance price. Then pay the lower one. Sometimes cash wins.
  2. Ask your prescriber if a generic or lower-cost choice could work for you. Generics often cost far less.
  3. Ask for a 90-day supply. It can cost less per pill and saves trips.
  4. Compare pharmacies. The same pills can cost very different amounts at different stores. Compare drug prices.
  5. Check mail-order pharmacies that post cash prices. Some charge much less for common generics. See U.S. mail-order pharmacies.
  6. On Medicare? Apply for Extra Help. It’s free to apply, and it can cut drug costs to a few dollars. Apply at SSA.gov.
  7. On Medicare? Your drug costs stop at $2,100 in 2026 ($2,400 in 2027). Spread big bills over the year with the free Medicare Prescription Payment Plan.
  8. Low income or no insurance? See if you qualify for Medicaid or a Marketplace plan with tax credits. Start at HealthCare.gov.
  9. Ask the drug’s maker for help. Many makers give free or low-cost medicine to people who qualify.
  10. Have an HSA or FSA? Use it. You pay for medicine with money that isn’t taxed.

What’s in this guide

🦉 Ask Hoot

Not sure which chapter is for you? Hoot, our savings owl, can point you to the right part of this guide. On a medicine’s page, Hoot also shows our latest checked prices, whether a generic is sold, and any FDA shortage or recall notice.

Ask Hoot

Hoot gives information, not medical advice. Your prescriber decides which medicine is right for you.

Chapter 1: Start here and find your path

In short

Most people can pay less for medicine. The trick is knowing which door to knock on first. Find your situation below and start there.

Drug prices in the U.S. can feel like a maze. The same medicine can cost $10 at one place and $100 at another. Your insurance might help, or it might not. And there are dozens of programs with long names.

Here’s the good news. You don’t need to learn all of it. You just need the few steps that fit you.

Pick your situation

Your situationStart hereThen check
No health insuranceChapter 4: cash prices, health centers and maker programsMedicaid or a Marketplace plan (Chapter 9)
You have Medicare (most people 65 and older)Chapter 5: the $2,100 cap and Extra HelpMedicare Savings Programs and SHIP help (Chapter 9)
You have insurance, but your costs are still highChapter 6: appeals, copay cards and cash pricesAn HSA or FSA (Chapter 8)
Medicaid or low incomeChapter 7: what Medicaid coversHealth centers and other programs (Chapter 9)

Find your lowest legal cost in 5 steps

  1. Know your medicine. Write down the name, the strength (like 10 mg) and how many you take each month.
  2. Ask about lower-cost choices. Ask your prescriber or pharmacist: “Is there a generic or a cheaper option that could work for me?” Your prescriber decides which medicine is right for you.
  3. Get two prices. Ask your pharmacy for your insurance price and the cash price. Check a mail-order pharmacy too.
  4. Check for help programs. Look at Extra Help (Medicare), Medicaid, the drug maker’s program, and the programs in Chapter 9.
  5. Pick the lowest safe option. Use a licensed pharmacy. Then set a reminder to check again next year, because prices and plans change.

💰 Money Saver

Say your inhaler costs $300 a month with your insurance. You ask the pharmacist about a generic, and your prescriber says yes. The generic might cost a small part of that. Always ask. It’s free to ask.

👉 Your next step

Jump to the chapter that fits you in the table above. Keep a notepad handy for your medicine names and prices.

Chapter 2: Health insurance in plain English

In short

Insurance has its own words. Once you know six of them, you can compare plans and spot where you’re losing money.

The six words that cost you money

  • Premium. What you pay each month to have the plan. You pay it even if you never see a doctor.
  • Deductible. What you pay before the plan starts to pay. If your deductible is $1,000, you pay the first $1,000 of covered care yourself.
  • Copay. A set dollar amount, like $15 for a medicine.
  • Coinsurance. A percent of the cost, like 25%. If the medicine costs $200, you pay $50.
  • Out-of-pocket maximum. The most you’ll pay in a year for covered care. After that, the plan pays 100%.
  • Formulary. The plan’s list of covered drugs. A drug not on the list may cost you full price.

📌 Remember

A low premium often means a high deductible. A high premium often means you pay less when you get care. The cheapest plan each month isn’t always the cheapest plan for the year.

Drug tiers: why one pill costs $5 and another costs $80

Most plans put drugs into groups called tiers. Each tier has a different price. Medicare says a drug in a lower tier will generally cost you less than one in a higher tier, and tier 1 usually holds most generics (Medicare.gov).

So if your medicine is on a high tier, ask your prescriber if a lower-tier drug could work for you.

How to choose a plan that saves you money

  1. List your medicines and doctors. Write them all down.
  2. Check each plan’s drug list. Make sure your medicines are on it, and see which tier they’re on.
  3. Check the network. Are your doctors and pharmacy “in network”? Out-of-network care costs more.
  4. Add up a full year. Premiums times 12, plus what you’d likely pay for care and drugs. Compare that total, not just the monthly price.
  5. Look at the out-of-pocket maximum. If you take costly medicine, a lower maximum can save you a lot.

Where health insurance comes from

  • Your job. Many employers offer plans. They often pay part of the premium.
  • The Marketplace. You can buy a plan at HealthCare.gov or your state’s site. Many people get tax credits that lower the price. See Chapter 9.
  • Medicare. For most people 65 and older, and some younger people with disabilities. See Chapter 5.
  • Medicaid and CHIP. Free or low-cost coverage for people with low income, and for kids. See Chapter 7.
  • Military, veterans and tribal health programs. See Chapter 9.

💡 Tip

Open Enrollment for 2027 Marketplace plans started November 1, 2026. To have coverage start January 1, sign up by December 15. The last day to enroll for 2027 is January 15, 2027 (HealthCare.gov, as of October 29, 2026).

👉 Your next step

Find your plan’s drug list (formulary). Look up each of your medicines and write down its tier.

Chapter 3: How to shop for the lowest price

In short

The price of a medicine isn’t one price. It depends on where you buy it and how you pay. A few minutes of comparing can save you a lot.

Why prices are all over the place

Drug prices in the U.S. are set by deals between drug makers, insurance plans, pharmacies and middlemen called PBMs (pharmacy benefit managers). A PBM is a company that runs the drug part of many insurance plans. You don’t see these deals. You just see the price at the counter.

That’s why shopping around works.

Four places to look

1. Mail-order pharmacies that post their cash prices. These are U.S. pharmacies that mail medicine to your door. Some post low cash prices for common generics right on their sites. We’ve profiled these:

Amazon Pharmacy also mails prescriptions. See all of them on our U.S. online pharmacies page.

2. Your local pharmacy. Stores like CVS, Walgreens, Walmart and Costco fill prescriptions in person. Prices change from store to store and ZIP code to ZIP code. Discount cards (for example GoodRx or SingleCare) may lower the price at local pharmacies; prices vary by pharmacy and ZIP code.

3. The drug maker. Many makers sell brand-name drugs at a set cash price. Some mail it to you. Others give you a coupon to use at your pharmacy. Many also run free-medicine programs for people with low income. These are called patient assistance programs. Directories like NeedyMeds list these programs by drug.

4. TrumpRx.gov. This is a federal website that started on February 5, 2026. It lists cash prices that drug makers agreed to offer (White House). Medicare says you can’t buy drugs directly from TrumpRx. You use its offers at your pharmacy or through the maker (Medicare.gov). Visit TrumpRx.gov to see if your drug is listed.

⚠️ Watch Out

If you pay cash or use a discount card instead of your insurance, that money usually doesn’t count toward your plan’s deductible or yearly limit. Medicare says this plainly for TrumpRx and other discount cards (Medicare.gov). If you’ll hit your deductible anyway, run the numbers both ways.

Compare prices in one place

eDrugSearch shows prices from U.S. pharmacies and pharmacies abroad side by side, with the date we checked each one. Search your medicine on our drug prices page. The prices are free to see. Members also see which pharmacy has each price.

Simple ways to pay less at any pharmacy

  • Ask for the generic. A generic has the same active ingredient as the brand. Ask your prescriber or pharmacist if one is available for you.
  • Ask for 90 days. A 90-day supply often costs less than three 30-day fills. Ask your prescriber to write it that way if it’s right for you.
  • Ask “Is there a lower-cost option?” Sometimes a different medicine in the same family costs much less. Only your prescriber can decide if it’s right for you.
  • Ask your pharmacist to run it both ways. Insurance price and cash price. Pick the lower one.

💡 Tip

Call ahead. Pharmacies will often tell you a cash price over the phone. Have the drug name, strength and number of pills ready.

Quick Answers

Is a generic as good as the brand?

A generic has the same active ingredient as the brand. If you have questions about your own medicine, ask your pharmacist.

Can I use a discount card if I have insurance?

Yes, you can choose to pay that way instead of using insurance. Just know the money usually won’t count toward your deductible or yearly limit.

👉 Your next step

Look up your medicine on our drug prices page, then call your pharmacy and ask for the cash price and the insurance price.

Chapter 4: No insurance? Start here

In short

You have more options than you might think. First, check if you qualify for free or low-cost coverage. Then use cash prices, health centers and maker programs to pay less.

Step 1: See if you can get coverage

Many people without insurance qualify for help and don’t know it.

  • Medicaid. Free or low-cost coverage for people with low income. You can apply any time of year (HealthCare.gov).
  • A Marketplace plan with tax credits. If your income is between 100% and 400% of the federal poverty level, you may get a tax credit that lowers your monthly bill (HealthCare.gov).
  • CHIP for kids. Free or low-cost coverage for children, and in some states pregnant women, when the family earns too much for Medicaid.

Lost your job or your coverage? You can often sign up outside Open Enrollment. You usually have 60 days. See the Marketplace box in Chapter 9.

Step 2: Use a community health center

Health centers give primary medical and dental care, whether or not you have insurance. They charge on a sliding fee scale, based on what you can pay (HRSA). Ask the front desk if they offer lower-cost medicine too.

Find one near you at findahealthcenter.hrsa.gov.

Step 3: Shop cash prices

Use the four places to look from Chapter 3. For many generics, a U.S. mail-order pharmacy is a good first stop.

Step 4: Ask the drug maker

If you take a brand-name drug, go to the maker’s website. Look for words like “patient assistance” or “savings.” Some programs give medicine for free to people under an income limit.

💰 Money Saver

Say you need a brand-name medicine that costs $500 a month at the pharmacy. The maker’s patient assistance program might give it to you free if your income is low enough. You’ll usually fill out a form, and your prescriber signs part of it.

⚠️ Watch Out

Never buy from a website that sells prescription medicine without asking for a prescription. That’s a red flag from the FDA. See Chapter 10 for how to spot fake pharmacies.

Quick Answers

Can I get free prescriptions?

Sometimes. Medicaid, drug maker programs and some health centers can bring costs to $0 or close to it if you qualify.

What’s the cheapest way to buy prescriptions without insurance?

Compare cash prices at mail-order and local pharmacies, ask for generics and 90-day supplies, and check maker programs. There’s no single cheapest place for every drug.

👉 Your next step

Go to HealthCare.gov and see if you qualify for Medicaid or a lower-cost plan. It takes a few minutes.

Chapter 5: Medicare and your medicine

In short

Medicare drug costs now have a yearly cap: $2,100 in 2026 and $2,400 in 2027. Extra Help can cut costs even more. And you can switch plans every fall to save.

How Medicare drug coverage works

Medicare’s drug coverage is called Part D. You can get it two ways:

  • A stand-alone drug plan. You keep Original Medicare and add a Part D plan.
  • A Medicare Advantage plan with drug coverage. One private plan covers your doctor, hospital and drug costs.

Either way, you pay a monthly premium (some plans are $0), plus your share of each medicine.

The big money rules for 2026 and 2027

Rule20262027
Most you’ll pay for covered drugs in a year$2,100$2,400
Highest deductible a plan can have$615$700
Insulin, per month, for each covered insulinNo more than $35, no deductibleNo more than $35, no deductible
Shingles shot with Part D$0$0

Sources: Medicare.gov drug costs, Medicare.gov insulin, Medicare.gov shingles vaccine. As of October 29, 2026.

Once you reach the yearly cap, you pay nothing more for covered Part D drugs for the rest of that year (Medicare.gov).

💰 Money Saver

Here’s how the cap can work in a standard plan. Say your covered medicine costs $1,000 a month. In January you pay the $615 deductible, then 25% of the rest. You keep paying 25% each month. By July you reach the $2,100 cap. From then on, you pay $0 for covered drugs until next year. (Your plan’s exact copays may be different.)

Spread big costs over the year: the Medicare Prescription Payment Plan

Big bills in January can hurt. This free option lets you pay your drug costs in monthly amounts instead of all at the pharmacy. Medicare is clear that it “doesn’t save you money or lower your drug costs.” It just spreads them out (Medicare.gov).

It helps most if you have high costs early in the year. Signing up before September gives you more months to spread the cost. To sign up, call your drug plan or visit its website.

Extra Help: the biggest Medicare savings most people miss

Extra Help is a Medicare program that helps pay your Part D premium, deductible and copays. Social Security says it’s worth about $5,700 a year (SSA). In 2026, you pay no more than $12.65 for each covered drug with Extra Help (Medicare.gov).

2026 limits (SSA, August 2026):

Yearly income underResources under
One person$23,940$18,090
Married couple living together$32,460$36,100

Resources are things like bank accounts and stocks. Your home, car and personal things don’t count. Some people with higher income can still qualify, like people who support family members or live in Alaska or Hawaii.

See the Extra Help box in Chapter 9 for how to apply.

💡 Tip

Even if you think you’re over the limit, apply. It’s free, and Social Security makes the call. When you apply, Social Security also sends your information to your state to start a Medicare Savings Program application, unless you say no (Medicare.gov).

Lower prices Medicare negotiated

Medicare now negotiates prices for some of its costliest drugs. The first 10 negotiated prices started January 1, 2026: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp and NovoLog insulin (CMS).

Fifteen more start January 1, 2027 (CMS): Ozempic, Rybelsus and Wegovy; Trelegy Ellipta; Xtandi; Pomalyst; Ofev; Ibrance; Linzess; Calquence; Austedo and Austedo XR; Breo Ellipta; Xifaxan; Vraylar; Tradjenta; Janumet and Janumet XR; and Otezla.

In January 2026, CMS picked 15 more drugs for prices starting January 1, 2028, including Trulicity, Biktarvy and Xolair (CMS).

What this means for you: if you take one of these drugs, the lower price can lower what you pay, especially while you’re in your deductible or paying a percent of the cost.

The Medicare GLP-1 Bridge

Since July 1, 2026, a temporary Medicare program covers certain weight-loss medicines (Wegovy, Zepbound KwikPen and Foundayo) for a $50 copay for a one-month supply, for people with Part D who meet body weight and health rules. Your provider must send a prior approval. This $50 doesn’t count toward your yearly cap (Medicare.gov). Ask your prescriber if it fits you, or call 1-800-MEDICARE.

Pick a better plan every fall

Plans change their prices and drug lists every year. Medicare’s Open Enrollment runs October 15 to December 7 each year (Medicare.gov). That’s your chance to switch.

  1. Read your plan’s “Annual Notice of Change” letter. It shows what’s changing next year.
  2. Go to the Medicare Plan Finder.
  3. Enter your medicines and your pharmacy.
  4. Sort by lowest total cost for the year, not just the premium.
  5. Want free help? Call your local SHIP. See Chapter 9.

📌 Remember

A plan that was cheap for you this year may not be cheap next year. Check every fall, even if you’re happy.

If your plan won’t cover your drug

You or your prescriber can ask the plan for an exception. That’s when a plan agrees to cover a drug that’s not on its list, or to lower its tier. Your prescriber must send a statement that explains why you need it (Medicare.gov). If the plan says no, you can appeal.

Coupons, cash and Medicare

  • Drug maker copay coupons can’t be used with Medicare drug coverage. The government’s watchdog says these coupons count as a kind of payment to get you to buy a drug, which raises problems under the federal anti-kickback law when Medicare Part D pays for the drug (HHS-OIG, 2014).
  • You can pay cash or use a discount card instead of your plan. But that money doesn’t count toward your deductible or the yearly cap (Medicare.gov).
  • Maker free-medicine programs may still help. Some patient assistance programs work outside your Part D plan. Check the program’s own rules.

Help from your state

Some states have a State Pharmaceutical Assistance Program, or SPAP, that helps pay for drugs. Check if your state has one with Medicare’s SPAP tool.

Quick Answers

What is the Medicare Part D out-of-pocket maximum?

$2,100 in 2026 and $2,400 in 2027 for covered drugs. After that, you pay $0 for covered drugs for the rest of the year.

Does a discount card count toward my Medicare cap?

No. Medicare says discount cards and TrumpRx don’t count toward your deductible or out-of-pocket maximum.

👉 Your next step

If your income is limited, apply for Extra Help today. If not, put October 15 on your calendar and compare plans.

Chapter 6: You have insurance, but it still costs too much

In short

Insurance doesn’t always mean low prices. Your plan’s rules can be challenged, maker cards can help, and sometimes cash is cheaper than your copay.

First, find out why it costs so much

Look at your plan’s drug list or call the number on your card. Ask:

  • Is my drug covered?
  • What tier is it on?
  • Do I have to meet my deductible first?
  • Is there a lower-tier drug that treats the same thing?

Then take those answers to your prescriber.

Prior authorization and step therapy

  • Prior authorization means your plan wants your prescriber to explain why you need a drug before it pays.
  • Step therapy means your plan wants you to try a cheaper drug first.

These are not always a “no.” Your prescriber can send the plan the reasons you need the drug.

Appeal a “no”

If your plan denies a drug, you can appeal. Here’s how it works for most plans (HealthCare.gov):

  1. File within 180 days of the denial notice.
  2. The plan decides within 30 days if you haven’t gotten the care yet, or 60 days if you have.
  3. Urgent? The plan must decide as fast as your health needs, and no later than 4 business days.
  4. Still no? Ask for an external review. That’s when an outside group looks at the decision (HealthCare.gov).

💡 Tip

Ask your prescriber’s office for help. Many offices do these forms all the time. Keep copies of every letter and write down the date and name of everyone you talk to.

Copay cards from drug makers

Many brand-name makers offer copay cards. These lower what you pay at the pharmacy, sometimes a lot. They’re usually only for people with insurance through work or a private plan, not Medicare or Medicaid. Check the card’s rules on the maker’s website.

⚠️ Watch Out

Some plans don’t count copay card money toward your deductible or out-of-pocket maximum. These are sometimes called “copay accumulator” or “maximizer” programs. When the card runs out, you might suddenly owe a lot. Call your plan and ask how it treats copay cards.

Sometimes cash is cheaper

If you haven’t met your deductible, you might pay the full insurance price. A cash price at a mail-order pharmacy or a discount card price might be lower. Just remember that cash usually won’t count toward your deductible.

💰 Money Saver

Say your generic blood pressure pill costs $45 a month through insurance because you haven’t met your deductible. A mail-order pharmacy might sell 90 days of the same generic for less than one month at your copay. Check prices on our drug prices page.

Use your HSA or FSA

If you have a Health Savings Account or Flexible Spending Account, pay for medicine with it. That money isn’t taxed. See Chapter 8.

Quick Answers

Why is my medicine so expensive even with insurance?

Usually it’s the deductible, a high tier, or the drug not being on your plan’s list. Each one has a fix to try: a lower-tier option, an exception, an appeal, a copay card or a cash price.

👉 Your next step

Call your plan and ask the four questions at the top of this chapter. Write down the answers.

Chapter 7: Medicaid and low income

In short

Medicaid covers prescription drugs in every state, with small copays or none. If your income is low, apply. You can apply any time of year.

What Medicaid gives you

Medicaid is free or low-cost health coverage run by each state. It covers doctor visits, hospital care and prescription drugs. Federal rules keep copays small. For medicines, the federal maximums are a few dollars for preferred drugs, and some groups, like children, pay nothing (Medicaid.gov). Your state may charge less.

Who can get it

It depends on your state. In states that expanded Medicaid, most adults with income below 138% of the federal poverty level qualify (HealthCare.gov). Medicaid.gov’s latest map shows 40 states plus D.C. have expanded. Other states have different rules, often for children, parents, pregnant women and people with disabilities.

How to apply

See the Medicaid box in Chapter 9. The short version: apply at HealthCare.gov or with your state Medicaid agency.

Changes starting in 2027

A 2025 federal law changes some Medicaid rules for adults who got Medicaid through expansion (Medicaid.gov):

  • Work rules. By January 1, 2027, states must require many adults ages 19 to 64 to show 80 hours a month of work, school, community service or a work program. Many people don’t have to, like pregnant women, parents of young children and people who are medically frail (CMS).
  • Renewing every 6 months. Expansion adults will renew every six months for renewals on or after January 1, 2027.
  • Copays later. Starting October 1, 2028, some expansion adults above 100% of the poverty level may pay copays of up to $35 per service.

⚠️ Watch Out

Watch your mail. If your state sends a renewal form or asks for proof of work hours, answer by the deadline. Missing a letter is one of the most common ways people lose coverage they still qualify for.

More help if your income is low

  • Health centers charge by what you can pay. See Chapter 4.
  • Drug maker programs give free medicine to many people with low income.
  • Rx Outreach is a nonprofit mail-order pharmacy with low prices. Anyone with a prescription can use it. See our profile.
  • CHIP covers kids when the family earns too much for Medicaid.

Quick Answers

Does Medicaid pay for prescriptions?

Yes. Every state’s Medicaid program covers outpatient prescription drugs (Medicaid.gov). Each state has its own list of preferred drugs.

Can I get Medicaid and Medicare at the same time?

Yes. Many people have both. Medicaid can help pay Medicare costs, and you’ll also get Extra Help for drugs.

👉 Your next step

Check if you qualify at HealthCare.gov or call your state Medicaid office.

Chapter 8: HSAs, FSAs and HRAs: pay for medicine with tax-free money

In short

These accounts let you pay for medicine and care with money that isn’t taxed. That’s like an instant discount. An HSA can even grow year after year.

How an HSA saves you money

A Health Savings Account (HSA) is a bank account just for health costs. It saves you money three ways (IRS Publication 969):

  1. Money goes in before tax. You can deduct what you put in, even if you don’t itemize.
  2. It grows tax-free. Interest and earnings aren’t taxed.
  3. It comes out tax-free when you pay for qualified medical costs, like prescriptions.

The money is yours. It stays in the account until you use it, even if you change jobs.

💰 Money Saver

Say you’re in the 22% federal tax bracket and you put $1,000 in your HSA. You’d save about $220 in federal income tax. Then you use that $1,000 to pay for your medicine. That’s like getting your medicine 22% off.

Who can have an HSA

You can put money in an HSA if (IRS Publication 969):

  • You have an HSA-eligible high-deductible health plan (HDHP).
  • You have no other health coverage, except kinds the rules allow.
  • You aren’t enrolled in Medicare.
  • No one can claim you as a dependent on their taxes.

New in 2026: Bronze and catastrophic plans bought through the Marketplace now count as HSA-eligible plans (IRS Notice 2026-5).

How much you can put in

20262027
HSA limit, just you$4,400$4,500
HSA limit, family$8,750$9,000
Extra if you’re 55 or older$1,000$1,000
Plan’s lowest deductible to qualify (just you / family)$1,700 / $3,400$1,750 / $3,500
Plan’s highest out-of-pocket limit (just you / family)$8,500 / $17,000$8,700 / $17,400

Sources: IRS Rev. Proc. 2025-19 (2026), IRS Rev. Proc. 2026-24 (2027), IRS Publication 969 (age 55 extra).

What you can pay for

  • Prescription medicines and insulin (IRS Publication 502).
  • Over-the-counter medicine, with or without a prescription (IRS Publication 969).
  • Menstrual care products.
  • Doctor visits, dental care, glasses and many other medical costs.

Paying cash prices and mail order with your HSA

You can use your HSA card at U.S. pharmacies, including mail-order pharmacies, when you pay a cash price. Keep your receipts.

⚠️ Watch Out

Medicine from other countries. The IRS says that, in general, you can’t count the cost of a prescribed drug brought in or ordered from another country. You can only count a drug that was imported legally, such as one the FDA says individuals can legally import. A drug you buy and use while you’re in another country can count if it’s legal in both countries (IRS Publication 502). Ask a tax professional before using HSA money for an order from abroad.

FSAs in brief

A Flexible Spending Account (FSA) is offered through your job. You choose how much to put in from your paycheck before tax. In 2026, the limit is $3,400. If your plan allows carryover, you can carry up to $680 into the next year (IRS Rev. Proc. 2025-32). Other money left at the end of the year can be lost, so plan carefully. You don’t need a high-deductible plan for an FSA. Over-the-counter medicine counts here too.

HRAs in brief

A Health Reimbursement Arrangement (HRA) is money your employer sets aside to pay you back for medical costs. Only your employer puts money in. It isn’t taxed, and unused money can often roll over (IRS Publication 969). Ask your HR office what yours covers.

How to open an HSA, step by step

  1. Check your plan. Make sure it’s an HSA-eligible plan. Your plan papers or HR office can tell you. Marketplace bronze and catastrophic plans count starting in 2026.
  2. Ask your job first. Many employers offer an HSA and may add money to it. Payroll deductions also skip some payroll taxes.
  3. No HSA at work? Open one yourself. Many banks and investment firms offer HSAs. Compare monthly fees and how you can invest.
  4. Put money in. Stay under the yearly limit. Count any money your employer adds.
  5. Use the HSA card for prescriptions, or pay yourself back later from the account.
  6. Keep every receipt. You may need them at tax time. You’ll report your HSA on IRS Form 8889 with your taxes.

📌 Remember

If you take money out for things that aren’t medical, you’ll owe income tax on it, plus an extra 20% tax if you’re under 65 (IRS Publication 969). Use it for health costs only.

Quick Answers

Can I use my HSA for prescriptions?

Yes. Prescription medicines and insulin are qualified medical expenses. Over-the-counter medicine counts too.

Can I keep my HSA after I join Medicare?

Yes. You can keep the account and spend the money on medical costs. You just can’t put new money in once you’re enrolled in Medicare.

👉 Your next step

Check if your health plan is HSA-eligible. If you have an FSA, look at your balance and plan to use it before the deadline.

Chapter 9: Every government program that can help you pay

In short

Here’s every major government program that helps with health care or insurance costs. Each one has who qualifies, what you get, and exactly how to apply. All of them are free to apply for.

📌 Remember

Rules and dollar limits below are as of October 29, 2026. They change. Always check the official link before you decide.

Medicaid

Who qualifies: People with low income. In most states, that includes adults under 138% of the poverty level. Rules differ by state.

What you get: Free or very low-cost health care and prescriptions.

✅ What to do

  1. Go to HealthCare.gov and fill out an application, or contact your state Medicaid agency.
  2. Have your income, household size and ID ready.
  3. Apply any time of year.
  4. Watch your mail and answer every letter by its deadline.

Official link: healthcare.gov/medicaid-chip

CHIP (Children’s Health Insurance Program)

Who qualifies: Children (and pregnant women in some states) in families that earn too much for Medicaid.

What you get: Free or low-cost coverage. Well-baby and well-child care can’t have any cost sharing (Medicaid.gov).

✅ What to do

  1. Apply on HealthCare.gov or with your state Medicaid agency. The same application covers CHIP.
  2. List every child in your household.
  3. Apply any time of year.

Official link: healthcare.gov/medicaid-chip

Marketplace plans with tax credits and lower copays

Who qualifies: People who buy their own insurance. Tax credits are for people with income between 100% and 400% of the poverty level (HealthCare.gov). Starting January 1, 2027, only people with certain immigration statuses can get the savings (HealthCare.gov).

What you get: A premium tax credit lowers your monthly bill. Cost-sharing reductions lower your deductible and copays, but only if you pick a Silver plan (HealthCare.gov).

✅ What to do

  1. Go to HealthCare.gov (or your state’s own site, if it has one).
  2. Enter your expected income for the year.
  3. Compare plans. If you qualify for lower copays, look at Silver plans.
  4. Enroll between November 1, 2026 and January 15, 2027 for 2027 coverage. Enroll by December 15 for coverage that starts January 1.
  5. Had a life change, like losing coverage, moving or having a baby? You usually have 60 days to sign up outside Open Enrollment (90 days if you lose Medicaid or CHIP) (HealthCare.gov).
  6. If your income changes during the year, update your application.

Official link: healthcare.gov, or call 1-800-318-2596

Medicare (signing up)

Who qualifies: Most people 65 and older, and some younger people with disabilities.

What you get: Hospital (Part A), doctor (Part B) and drug (Part D) coverage.

✅ What to do

  1. Sign up during the window that starts 3 months before the month you turn 65 and ends 3 months after it (Medicare.gov).
  2. Don’t wait without a good reason. A late Part B sign-up can mean a monthly penalty for as long as you have Part B.
  3. Choose a drug plan using the Medicare Plan Finder.
  4. Review your coverage every year between October 15 and December 7.

Official link: medicare.gov, or call 1-800-MEDICARE (1-800-633-4227)

Medicare Savings Programs

Who qualifies: People with Medicare and limited income and savings. 2026 monthly income limits for one person are $1,350 (QMB), $1,616 (SLMB) and $1,816 (QI). The savings limit is $9,950 for one person or $14,910 for a couple (Medicare.gov). Some states use higher limits.

What you get: Help paying your Part B premium. The QMB program also pays Part A and B deductibles, coinsurance and copays. People in QMB, SLMB or QI also get Extra Help for drugs.

✅ What to do

  1. Call or visit your state Medicaid office. Medicare Savings Programs are run by states.
  2. Apply even if you think you’re a little over the limit. Your state decides.
  3. If you’re in QI, reapply every year.

Official link: medicare.gov/basics/costs/help/medicare-savings-programs

Extra Help (Medicare drug costs)

Who qualifies: People with Medicare with 2026 income under $23,940 (one person) or $32,460 (couple), and resources under $18,090 or $36,100 (SSA).

What you get: Help with Part D premiums, deductibles and copays. In 2026, no more than $12.65 per covered drug.

✅ What to do

  1. Apply online at ssa.gov/medicare/part-d-extra-help.
  2. Or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
  3. Or go to your local Social Security office.
  4. Have your bank, income and investment information ready.
  5. Free help with the form is available from your SHIP.

Official link: ssa.gov/medicare/part-d-extra-help

SHIP: free Medicare counseling

Who qualifies: Anyone with Medicare, plus family and caregivers.

What you get: Free, unbiased, one-on-one help choosing plans and applying for programs (SHIP). They don’t sell plans.

✅ What to do

  1. Go to shiphelp.org and find your state’s SHIP.
  2. Call and ask for an appointment.
  3. Bring your Medicare card, your list of medicines and your current plan’s letters.

Official link: shiphelp.org

PACE (Programs of All-inclusive Care for the Elderly)

Who qualifies: People 55 or older who live in a PACE area, need a nursing home level of care (as certified by the state), and can live safely at home with PACE’s help (Medicare.gov).

What you get: All your care, including drugs, from one team. No deductible or copay for care your PACE team approves. With Medicaid, there’s no monthly premium.

✅ What to do

  1. Search for PACE plans near you in the Medicare Plan Finder.
  2. Call your state Medicaid office to check if you qualify.

Official link: Medicare.gov PACE page

State Pharmaceutical Assistance Programs (SPAPs)

Who qualifies: It depends on your state. Not every state has one.

What you get: Help paying for prescriptions, often on top of Medicare.

✅ What to do

  1. Use Medicare’s SPAP tool to see if your state has a program.
  2. Follow your state program’s steps to apply.
  3. Ask your SHIP for help if you get stuck.

Official link: go.medicare.gov/spap

VA health care and VA pharmacy

Who qualifies: Many veterans. VA decides based on service and other factors.

What you get: Health care and low-cost medicine. Since January 1, 2026, VA medication copays are $5 (tier 1), $8 (tier 2) and $11 (tier 3) for a 1 to 30 day supply, and they stop once you’ve paid $700 in a year. Some veterans pay no medication copays at all, like those rated 50% or more service-connected (VA).

✅ What to do

  1. Apply online at va.gov/health-care/how-to-apply using VA Form 10-10EZ.
  2. Or call 877-222-8387.
  3. Or apply by mail or in person at a VA medical center.

Official link: va.gov/health-care/how-to-apply

TRICARE (military families and retirees)

Who qualifies: Service members, retirees and their families.

What you get: Prescription coverage. Military pharmacies charge $0. In 2026, home delivery costs $14 for a generic and $44 for a brand for up to 90 days. Retail network pharmacies cost $16 and $48 for up to 30 days. Active duty members pay nothing for covered drugs (TRICARE).

💰 Money Saver

Home delivery gives you up to 90 days for less than a 30-day fill at a retail pharmacy. Ask your prescriber for a 90-day prescription if it’s right for you.

✅ What to do

  1. Check your TRICARE pharmacy costs at tricare.mil/Costs/PharmacyCosts.
  2. To use home delivery, go to the Express Scripts military site at militaryrx.express-scripts.com.

Official link: tricare.mil/Pharmacy

Indian Health Service (IHS)

Who qualifies: Most often, enrolled members of a federally recognized tribe (IHS).

What you get: Health care at IHS and tribal facilities. IHS isn’t insurance. Prescriptions filled at outside pharmacies are usually your cost.

✅ What to do

  1. Find a facility near you on the IHS website.
  2. Go to the patient registration office.
  3. Bring proof that you’re enrolled in a federally recognized tribe.
  4. Call ahead to make sure they offer the care you need.

Official link: ihs.gov/forpatients

Community health centers (sliding-fee care)

Who qualifies: Everyone. You don’t need insurance.

What you get: Medical and dental care priced on a sliding scale, based on what you can pay (HRSA).

✅ What to do

  1. Go to findahealthcenter.hrsa.gov and enter your address.
  2. Call and ask about the sliding fee scale.
  3. Bring proof of income to your first visit.
  4. Ask if they have lower-cost medicine for patients.

Official link: findahealthcenter.hrsa.gov

340B clinics

What it is: Under the federal 340B program, health centers and some other clinics and hospitals can buy medicine at a discount (HRSA). It’s meant to help them stretch their money and serve more patients.

What you get: It depends on the clinic. Some use the savings to offer lower-cost medicine.

✅ What to do

  1. If you go to a health center or hospital clinic, ask: “Do you have a discount drug program for patients?”
  2. Ask if their pharmacy (or a partner pharmacy) has a lower price for you.

Official link: hrsa.gov/opa

Hill-Burton free and reduced-cost care

Who qualifies: People with income at or below the federal poverty guidelines get free care. People up to twice the guidelines can get reduced-cost care (HRSA).

What you get: Free or lower-cost care at about 127 hospitals and other facilities that still owe this care. It covers the facility’s costs only, not separate doctor bills.

✅ What to do

  1. Check the list of Hill-Burton facilities.
  2. Go to the facility’s admissions or business office and ask for a Hill-Burton eligibility decision.
  3. You can apply before or after care, even if the bill went to collections.
  4. Questions? Call 1-800-638-0742.

Official link: hrsa.gov/get-health-care/affordable/hill-burton

USA.gov benefit finder

What it is: A free government tool that shows you programs you might qualify for. It replaced Benefits.gov, which closed in 2024 (USA.gov).

✅ What to do

  1. Go to usa.gov/benefit-finder.
  2. Answer the questions about your life and needs.
  3. Follow the links to each program’s official site to apply.

Official link: usa.gov/benefit-finder

211

What it is: A phone line that connects you with local help, including help with medical and prescription costs (211).

✅ What to do

  1. Dial 211 from any phone.
  2. Say you need help paying for medicine or medical bills.
  3. Write down the names and numbers they give you.

Official link: 211.org

⚠️ Watch Out

You never have to pay anyone to apply for Medicare, Medicaid or Extra Help. If someone asks for money to “get you in,” hang up.

👉 Your next step

Pick the one or two programs above that fit you best and start the first step today.

Chapter 10: Buying medicine from other countries, safely

In short

Brand-name drugs often cost less abroad. But the law is strict, and rules for mail are changing in 2027. If you order, use a licensed pharmacy and keep to a 90-day supply.

What the law says

Federal law generally doesn’t allow individuals to import prescription drugs. Under its personal importation policy, the FDA has long used enforcement discretion for some personal-use shipments, generally no more than a three-month supply (FDA). Congress declared in FD&C Act 804(j)(1), 21 U.S.C. 384(j)(1), that enforcement against individuals should focus on imports posing a significant threat to public health (U.S. Code).

In plain words: it’s usually not legal, but the FDA has often let small personal orders through. That’s a choice the FDA makes, not a right you have. For the full story, read our guide to buying prescription drugs from Canada.

Mail is changing on January 20, 2027

U.S. Customs (CBP) set January 20, 2027 as the date a new electronic customs entry, called Entry Type 13, becomes required for international mail subject to Section 201/232/301 duties or under partner-agency (for example, FDA) jurisdiction. Current procedures are unchanged until then (CBP, October 14, 2026; Federal Register, October 22, 2026). A CBP proposal published October 8, 2026 would extend it to most other international mail worth $2,500 or less (Federal Register). Read what the 2027 customs rules mean.

State importation programs

The FDA has authorized Florida’s (January 2024) and Colorado’s (June 2026) programs (FDA). These are for bulk imports by the state, not for individual orders.

How to check a pharmacy

  1. It requires a valid prescription.
  2. It’s licensed where it’s based, and you can check that license yourself.
  3. It names the pharmacy that fills your order.
  4. It’s not on an FDA import alert.

We check these things before we list a pharmacy. See how we choose pharmacies and our list of Canadian pharmacies we checked.

FDA red flags for fake pharmacies

The FDA says a site may be unsafe if it (FDA BeSafeRx):

  • Doesn’t require a prescription
  • Isn’t licensed in the U.S. and by your state’s pharmacy board
  • Has no licensed pharmacist to answer questions
  • Offers prices that seem too good to be true
  • Sends medicine that looks different, is damaged, expired or in a foreign language
  • Charges you for things you didn’t order

⚠️ Watch Out

Never order controlled substances (like strong pain pills or ADHD medicine) by mail from another country. Importing them is a serious federal offense. eDrugSearch never lists them.

📌 Remember

HSA and FSA money generally can’t be used for medicine ordered from another country unless it was imported legally. See Chapter 8.

👉 Your next step

Before you order from abroad, compare it with U.S. options on our drug prices page. For many generics, a U.S. price is lower.

Chapter 11: Glossary: health care words in plain English

  • Appeal: Asking your plan to change a “no.”
  • Biosimilar: A biologic medicine that’s very close to an existing one, with no meaningful difference in safety or how well it works.
  • Brand-name drug: A medicine sold under the maker’s own name.
  • Cash price: What you pay without using insurance.
  • CHIP: Low-cost health coverage for kids.
  • Coinsurance: Your share of a cost, as a percent.
  • Copay: A set dollar amount you pay for a medicine or visit.
  • Copay accumulator: A plan rule that doesn’t count copay card money toward your deductible.
  • Copay card: A coupon from a drug maker that lowers your copay. Usually not allowed with Medicare or Medicaid.
  • Deductible: What you pay before your plan starts to pay.
  • Discount card: A free card that may lower cash prices at pharmacies.
  • Exception: When a plan agrees to cover a drug it normally wouldn’t, or at a lower tier.
  • Extra Help: A Medicare program that lowers drug costs for people with limited income.
  • Federal poverty level (FPL): An income amount the government uses to decide who gets help.
  • Formulary: Your plan’s list of covered drugs.
  • FSA: A work account for health costs, paid with pre-tax money.
  • Generic: A copy of a brand-name drug with the same active ingredient.
  • HDHP: A high-deductible health plan. You need one for an HSA.
  • HRA: Money your employer sets aside to pay you back for health costs.
  • HSA: A tax-free savings account for health costs.
  • Marketplace: Where you can buy your own health insurance, like HealthCare.gov.
  • Medicare Advantage: A private plan that covers your Medicare benefits, often with drug coverage.
  • Medicare Savings Program: State help paying Medicare costs, like the Part B premium.
  • NDC: A National Drug Code. It’s the number that identifies each drug product and package.
  • Network: The doctors and pharmacies your plan works with.
  • Out-of-pocket maximum: The most you’ll pay in a year for covered care.
  • Part D: Medicare’s drug coverage.
  • Patient assistance program: A drug maker’s program that gives free or low-cost medicine.
  • PBM: A pharmacy benefit manager. A company that runs the drug part of many plans.
  • Premium: What you pay each month to have a plan.
  • Prior authorization: Your plan wants a reason before it pays for a drug.
  • SHIP: Free, unbiased Medicare counseling in your state.
  • Special Enrollment Period: A chance to sign up for a plan after a big life change.
  • SPAP: A state program that helps pay for drugs.
  • Step therapy: Your plan wants you to try a cheaper drug first.
  • Tier: A price group on your plan’s drug list.

Chapter 12: Frequently asked questions

Who can help me pay for my prescriptions?

Start with the program that fits you. Medicare users can apply for Extra Help at SSA.gov. People with low income can apply for Medicaid. Drug makers often have free-medicine programs. Community health centers charge based on what you can pay. You can also dial 211 for local help.

How do I get my prescriptions for free?

You might qualify through Medicaid, a drug maker’s patient assistance program, PACE, or VA or military coverage. Each has its own rules. Check the programs in Chapter 9.

What is the Medicare Part D out-of-pocket maximum for 2026 and 2027?

It’s $2,100 in 2026 and $2,400 in 2027 for covered drugs. Once you reach it, you pay nothing more for covered Part D drugs that year.

How do I apply for Extra Help with Medicare?

Apply online at ssa.gov/medicare/part-d-extra-help, call Social Security at 1-800-772-1213, or visit a Social Security office. For 2026, income must be under $23,940 for one person or $32,460 for a couple, with resources under $18,090 or $36,100.

Is it cheaper to pay cash instead of using insurance?

Sometimes. Ask for both prices. But cash payments usually don’t count toward your deductible or yearly limit, so check how close you are to meeting them.

Can I use a drug maker’s coupon with Medicare?

No. Federal rules don’t allow maker copay coupons with Medicare drug coverage. You can pay cash or use a discount card instead of your plan, but that won’t count toward your Part D cap.

Can I use my HSA to pay for prescriptions?

Yes. Prescriptions, insulin and over-the-counter medicine are qualified expenses. Medicine ordered from another country generally doesn’t qualify unless it was imported legally.

What are the HSA limits for 2027?

$4,500 for just you and $9,000 for a family, plus $1,000 extra if you’re 55 or older. For 2026, the limits are $4,400 and $8,750.

When can I change my Medicare drug plan?

During Open Enrollment, October 15 to December 7 each year. Some people can change at other times, like after a move or if they get Extra Help.

Is it legal to buy prescription drugs from Canada?

Federal law generally doesn’t allow it. The FDA has long used discretion for some personal shipments of no more than a three-month supply. Read our guide to buying prescription drugs from Canada for details.

Sources

This guide explains health care costs and programs in plain English. It is general information, not medical, legal or tax advice. Your prescriber decides which medicine is right for you. Talk to your prescriber or pharmacist before you make any change to your medicine.

Rules, dollar limits and dates change. Every number here was checked on the official source listed above as of October 29, 2026. Always check the official link before you decide.

Pharmacies don’t pay to be listed, and nothing they do affects ratings or review order.