For many people in Medicare Part D, late summer is usually the time of year when they fall into the infamous Part D “doughnut hole,” which is the coverage gap that requires enrollees to pay all of their medication costs.
According to a Kaiser Family Foundation report, in 2007, about one in every four Part D enrollees who are not receiving low-income subsidies, fell into the doughnut hole. That represents more than 3 million people.
The report also found patients’ out-of-pocket drug costs doubled while in the doughnut hole. Sixteen percent stopped taking or reduced their medications and only 4 percent were able to climb out of the gap to reach catastrophic coverage.
AARP has an online tool that may help people who fall into the doughnut hole. It’s called the AARP Doughnut Hole Calculator. The tool guides consumers to options that can reduce their Part D spending by identifying less costly generic drugs or therapeutically similar alternatives.
“The calculator is easy to use,” said AARP Arizona State Director David Mitchell. “Just fill in your zip code, list your drugs and choose your health plan from the list that comes up. The results will give you a timeline as to how long your initial coverage will last before you hit the doughnut hole.”
AARP worked with DestinationRx, the designers of the Medicare.gov plan finder, to develop the online tool. The Doughnut Hole Calculator draws the drug pricing information directly from the Medicare.gov database, with the permission of the Centers for Medicare & Medicaid. This allows for as close-to-accurate pricing as possible. The calculator also provides more than generic substitutions: for many prescription medications, which are not yet available as generics, the tool generates therapeutically similar alternatives, a unique function among online tools.
The AARP Doughnut Hole Calculator can be found at www.aarp.org/doughnuthole.
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