Straight Medicare does not pay for Rx. Feds are trying to set caps on some common drugs like insulin, but a drug like Jakafi for orphan diseases like ours won't make it on that list.

You can buy advantage plans during open enrollment that may limit your co-pay. You can see if the drug mfctr will float you a lower price due to financial hardship. (Usually these last for just a year.) Or you may have been given a Medicare plan with drug coverage from your employer as a benefit when you retired that covers meds. Some seniors here in Michigan get their drugs cheaper from Canadian pharmacies.

Most Medicare drug plans do have "tiers" of meds in their formularies that are covered at certain rates. The formulary changes frequently. Call your Medicare plan to see what it pays.

If you are a low-income senior, your best bet is to ask for generics. And to consider writing your elected officials about those 20-year patents that drug makers are given during which they can charge prices for new drugs that put them out of reach for many of us.