When I first met many of my clients, they often tell me they are spending alot of money on prescriptions and their Part D drug plans are worthless.
Often times that is not the case. All Part D prescription drug plans cover you for the first $2970 (2013) dollars. So if you have a prescription that has a copay of let say $45, the actual retail price of that prescription may be $150, for example. The $150 is what’s applied towards the $2970. Once the $2970 is gone through, you get in the “donut hole” or the “coverage gap”. This is what you want to avoid, because your prescriptions become much more expensive. Now in years passed it was really expensive, but because of the health-care reform , 52.5% of your named brand drugs will covered and you will be responsible for the 47.5%.
There a few ways to avoid going into the Donut Hole:
1) Ask your doctor for samples. That could help you out for a month or two. That might not seem like much but it’s important to know because everything resets at the beginning of the new year.
2)With every prescription drug plan you are provided a formulary, which is a list of covered medicines. I urge you to take that formulary to the doctor and know exactly if your medicines are named brand or generic. Generics, typically, will save you a lot. If the doctor has prescribed you as named brand, ask if there is a generic equivalent that will do the same job from a health standpoint.
3) Many generics are covered at retailers like, Target, Wal-Mart, K-mart, Publix, Sweetbay, etc…. You can purchase your generics on the cheap without having to run it through your insurance. That will delay getting into the donut hole. Remember, if you get into the donut hole, you want to do it as late in the year as possible, because everything resets on January 1st.
4) If you are taking alot of prescription from different docotrs, speak to your primary care doctor and see how they all work with one another in your body. The docor may be able to eliminate some of your medicines.
If you would like more information for yourself, a family member or a friend. please call or email me.
“Medicare Dave” Silver