Part D Coverage Gap or “Donut Hole”
Medicare drug plans have a “coverage gap,” which is also been named the “donut hole.” A coverage gap means that after you and your plan have spent $2,510 for covered medications, you have to pay out-of-pocket the full price of your medications while you are in the “gap” . The gap ends once you have paid $4,050 in medications for the year. Every Medicare prescription drug plan has a gap in 2008.
There are a few programs and strategies that can be used by seniors to help reduce the costs of medications while in the coverage gap. The programs that provide the best assistance are Medicare’s Extra Help and Prescription Advantage, these two programs reduce the costs for Medicare Part D beneficiaries throughout the year including deductibles, copayments, premiums, and most importantly provide coverage during the gap. Other programs such as patient assistance programs through the drug companies that make the medications can help. Also co-pay assistance foundations can help lower the costs during the gap. Other strategies such as using a mail order program, visiting a pharmacy with lower prices, and reviewing your medications for lower cost alternatives can lower the costs of your monthly prescription costs.
MassMedLine staff can review your information and list of medications to see what programs and strategies can be used to help you. Pharmacists at MassMedLine can also review your list of medications to make recommendations on how you may work with your doctor to discuss lower costing alternative brand name medications or generic medications.