BUt they give exceptions. YOu just write a note and you get them. I've been doing it for years. I have Medicare also. I get Emsam ($500/month), Seroquel ($5000 per month), Nexium (don't know cost) and Amitiza (I think $300-500/month) all through patient assistance programs. I cannot pay any med that is past tier 2 on my drug plan so I use meds that have patient assistance and then ask to be exempted in.

You won't get exempted into the discount card program but the patient assistance where it is free you will.

My note just says something like "I am asking for an exception into your patient assistance program due to my inability to afford Rexulti despite having Medicare. My Medicare plan does not cover Rexulti and the cost is prohibitive out of pocket. The estimated cost is $900/month and that is ___% of my income which must also cover food, electric, psychotherapy, other medications, medical bills, etc. Rexulti is a very effective drug for me while others have not been and I do not want to have to stop taking due to cost. Could you please consider this application with an examption?". Within a few weeks you'll get approved.