It is so typical of the federal government to pretend to offer a solution to the populace only to give only partial relief.  This is what happened with Medicare Part D, prescription coverage.

Part D Medicare covers the cost of prescriptions up to $2700.  If the cost of an enrollee’s prescriptions exceeds $2700, then the enrollee must pay the next $3453 of their prescriptions drugs in full.  There will be no assistance in paying for this.  This is the donut hole.  You must pay for $3453 in prescriptions before another penny will be paid for by Part D Medicare.  That’s the equivalent of paying $287.75 per month to climb out of this hole.  This is in addition to paying the monthly premium for whatever plan that you selected plus the co-pay and deductible that you have already paid.

Many enrollees in Part D Medicare are blindsided when the hit $2700 in prescriptions expenses.  Even though each plans advises them of the $2700 limit, many do not understand what it means until they come face to face with the donut hole.

Unfortunately, in 2007 more than 50% of the enrollees fell into the hole by July and most would up paying for all their prescriptions for the remainder of the year.

There are ways that you can minimize your risk of ever reaching the $2700.

Request your physician to write your prescriptions for generics.  Generics are generally cheaper than brand names and are required to be just as effective by the FDA.

Request that your doctor writes all your prescriptions for 90 days as opposed to 30 days.  Mail-in prescriptions are generally much cheaper and you do not have to run to the pharmacy every 30 days to get your prescription filled.  Also many pharmacies have a list of generics drugs which they will fill for a set amount, such as $10 for a 90 day prescription.  Ask your pharmacy for a list of which drugs are covered under this plan.  Some of the larger retail stores haves pharmacies and also have similar plans.  This could be a significant savings if your drug is listed on their plan.

Some Medicare Part D plans offer some coverage for the donut hole, but these are usually the higher premium plans.  You should check these out, but be sure to compare the increased premium that you will be paying to what you will be paying in prescriptions charges.

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