Barbara Ingram-Rice: Learning to Navigate Drug Costs on Her Own Terms

When Barbara Ingram-Rice turned 65 in January 2026, she joked, “My favorite birthday card was my Medicare card.”

For years before that milestone, Barbara carefully managed her household’s health care coverage. Living in Sarasota, Florida, she worked as an occupational therapist while helping her husband navigate Medicare drug plans and managing her own insurance through the marketplace. As his primary caregiver, she reviewed coverage options each year to make sure their medications would be affordable. “I have been a primary caregiver for my husband for quite a number of years, and I always shopped his med plan every year to be sure that we’re going to be adequately covered,” she said.

That experience helped prepare her for many of the challenges of navigating the health care system. But even with that knowledge, Barbara encountered a major surprise when she transitioned to Medicare herself.

In 2023, Barbara began taking Jardiance and used a manufacturer coupon that brought the cost down to $10 per month. When she enrolled in Medicare, that changed immediately because manufacturer coupons are not allowed under government sponsored programs. “My $10 a month turned into $650 a month,” she said.

At the pharmacy, she learned that once she reached her annual out-of-pocket maximum of $2,000, the medication would be fully covered. But that still meant paying the full cost upfront early in the year. “I’m like, ‘But I don’t have $2000 right now for that.’” Even with the out-of-pocket cap, the timing felt unrealistic. “It’s January. Who’s got $2000 right now? My property taxes are due, that $2000 is what keeps me in my house.”

Barbara began searching for alternatives, spending significant time researching drug prices and coverage. She used the Medicare plan comparison tool, reviewed manufacturer information, and even consulted ChatGPT to better understand her options. “I actually went on the Medicare site and put in my drugs and that’s how I started to learn about what everything was going to cost,” she said. “I actually took all of that and went to ChatGPT. I’m like, okay. Is this a safe and effective drug?” When she spoke with the pharmacy staff, she asked them to explain the pricing, “Explain this to me because this math isn’t math-ing.”

During her research, she came across a newer medication in the same class, Brenzavvy. After discussing it with her doctor, she decided to switch. “I went from $650 a month to like $42 a month,” she said. The savings were significant. “When I did the math on that, I could get the whole year of Brenzavvy for less than what it cost me to get one month in Jardiance.”

Her experience as an occupational therapist helped her navigate the process, though she recognizes not everyone has the time or training to do the same.

Barbara’s insurance transition also created complications. Her marketplace plan dropped her primary care provider’s practice in July, months before she planned to enroll in Medicare, and she wanted to keep seeing the same doctor. “I really did not want to lose her as a primary,” she said. Rather than switch providers temporarily, she waited until her Medicare coverage began in January. During that time, she postponed screenings and delayed care, including stopping her medication while waiting for her appointment. “Because of the insurance and whatever, I ended up going without the med for probably 6 weeks,” she said.

Reflecting on her experience, Barbara believes policymakers should take stronger action on prescription drug prices. “I would just say you need to come down hard on these drug companies,” she said. She believes the steep discounts available through coupons show that lower prices are possible. “If they can give Jardiance to me for $10 a month for years, they can certainly afford to keep doing it,” she said. “I get that they’ve got to make a profit. They don’t need to make a year’s worth of profit off of every single person.”

For Barbara, the issue ultimately comes down to fairness and access to medications people rely on. “There are drugs that are life-giving in so many ways and they’re terribly expensive,” she said. “I just can’t even imagine how people can ask for thousands of dollars for drugs that people are literally dying without and then sleep at night.”