MEDICARE PART D: THE DOUGHNUT HOLE
The cost of Part D Medicaid insurance is increasing annually, but consumers must still deal with the coverage gap known as the “doughnut hole”. All of the plans available have this gap in coverage, which begins once an enrollee’s drug costs exceed a specific amount. In the year 2009, the amount has been set at $2,700. Once this amount has been reached, the enrollee must pay 100% of their drug costs for the year until the total reaches $4,350. At that time, their coverage will be resumed.
For many people, the “doughnut hole” keeps them from continuing on the medications. Many are doing without necessary drugs because they can’t afford them. Others are cutting back on their medication, trying to stretch the cost over a longer period of time. Doctors have expressed grave concern over this system that forces patients to stop their medication, while they are still making payments for this insurance coverage.
The best way for a patient to hold down their expenses is to talk with their doctor about the possibility of taking generic drugs, or older name-brand medications. Either of these alternatives might help them keep their drug expenses for the year under the “doughnut hole” amount, as these drugs are typically much less expensive than other newer drugs on the market. Only your doctor, however, can tell you if this is an option that is realistic for your particular health issues.