The Bitter Taste of the Medicare D Donut Hole on RX Drugs
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RX Drugs News: Donut holes used to be a good thing; buy a dozen and enjoy the sugar. But the Medicare D donut hole leaves nothing but a bitter taste for many senior Medicare beneficiaries. Seniors land in the hole once their total retail RX drugs costs reach $2,840. This is not true out-of-pocket spend, it is total retail drug cost. Once in the hole, seniors must pay 100% of prescription drugs costs until their true out-of-pocket figure reaches $4,550.
Medicare D Donut Hole Suggests Evaluate Plans Annually for Your RX Drugs Needs
The new health care bill passed into law March 2010, contains a provision aimed at closing the donut hole coverage gap by 2020. Closing the gap began in 2010 with rebates of $250 mailed out to seniors who fell into the hole. Beginning in 2011, seniors will receive 50% discount on brand drugs and a 7% discount on generic drugs. While seniors will pay for prescriptions after the discounts are applied, the entire prescription price will be applied to their out-of-pocket spend. As a result, seniors should come out of the gap sooner even though they must still reach $4,550 before coming out of the hole.
While attempts to close the gap are good; the gap will realistically not be closed for another nine years. During that time period, the potential to land in the hole suggests that seniors should re-evaluate their chosen prescription plans on an annual basis. This may be the best way to control true out-of-pocket costs for RX drugs and other necessary medication.
As medication needs change, with new and competitive plans in place, there may be significant savings available to seniors willing to switch. There is a tool available though Medicare.gov that can help seniors evaluate competing plans based on personal medication needs. The goal is to select a plan that provides coverage while in the Medicare D donut hole that will allow you to afford the RX drugs you need.
