If you’ve been around Medicare for any time at all, you’ve probably heard of the infamous “Donut Hole.” You may have heard horror stories or Medicare myths of people facing expensive bills because they were inside of the donut hole and how it can destroy a bank account, but many enrollees don’t’ really understand how the coverage gap works and how they can avoid the expensive consequences.
The donut hole refers to the coverage gap in Medicare Part D policies where an enrollee is responsible for paying a major portion of their prescription drug costs. Part D policies cover prescription drug costs up until a certain limit,; after that, you’ve entered the dreaded donut hole, then you’re going to be paying for 45% of brand-name drugs and 58% of generic medicines. Traditionally, enrollees were responsible for paying for 100% of the cost of drugs once they entered this section, but thanks to the recent health reform, this has changed drastically. The amount Medicare participants are responsible for paying is going to continue to decrease every year until 2020 when the donut hole will be eliminated.
Avoiding the Donut Hole
In four years, you won’t have to worry about the donut hole, but for the next couple years, you could end up spending extra money prescription drugs. If you’re trying to avoid the donut hole, there are several different options you have for purchasing your prescription drugs. You should never avoid taking any medications because of the price, but there are a few easy ways that you can save money on drugs and avoid the donut hole.
With the rise of the Internet, online pharmacies have gained significant popularity among seniors, especially those enrolled in Medicare Part D. Online stores are a great way to save money on the prescription drugs that you take every day. These online pharmacies offer the same drugs at a fraction of the price but be careful of which website you choose. Just like with every other online option, there are hundreds of pharmacies that are scams. So, how do you know which ones are legitimate?
The easiest way to check the legitimacy of pharmacy is to check it through online services like PharmacyChecker.com, which are third-party accreditors. We suggest only using online stores that have been verified by this service, or one like them.
Depending on what medications you take, your pharmacy could offer discounts for your prescription. These discounts could come from the manufacturer or from the pharmacy itself.
If you drugs don’t have any discount, ask your pharmacists if there is a generic version of your medications. The generic medications should have the same effectiveness as the brand name, but they are a fraction of the costs.
Because drug companies are always developing new drugs or coming out with new versions of medications, they are always offering free samples to potential costumers. Ask your pharmacist if they have any free samples that could benefit you, even if you don’t plan on switching, these samples could save you hundreds of dollars every year on your medications.
Increase Your Medication Order
Another easy way to save money on your medications is to change your prescription refills to every three months instead. Many pharmacies will allow you to buy three months worth of medications at once time, and normally this will save you money every month. Aside from spending less money on your drugs, you’ll also spend less time in the pharmacy lines.
Avoiding the Donut Hole
If you’re looking to avoid the expensive donut hole, or just save money on your monthly prescriptions, there are plenty of ways to do that. No Medicare enrollee should ever have to go without the medications just because they can’t afford them. If you can’t afford your medications once you’ve hit the donut hole, these are several options that may help relieve the financial strain.
MedicareWallet.com is an unbiased, online resource for individuals turning 65 or already on Medicare. Our utmost goal is to provide information in a way that is user-focused, informative and ethical. With a combined 40 years of experience in the Medicare market, we can answer any questions about Medicare and Medigap insurance. Feel free to reach out to us at 800.376.0824 or by email at [email protected].