Avoid the Coverage Gap

Posted by Kathy Quan Apr 4, 2007

In the fourth quarter of 2006, many Medicare Part D Prescription Drug Plan enrollees began to experience the Medicare Doughnut Hole. This coverage gap caught many seniors by surprise and without many options to help them out until coverage started over again in January.

Now the Centers for Medicare and Medicaid (CMS) has posted information and links to publications on their web site to assist beneficiaries in 1) avoiding the coverage gap and 2) finding resources to assist them with drug costs if they cannot avoid the coverage gap.

Seniors were encouraged to carefully research Part D Plans during Open Enrollment from November 15 to December 31 to fund the best fit for their particular needs.

One of the top 5 tips from CMS is to use generic drugs. The coverage gap begins when the patient and Medicare combined have paid out $2250 in drug costs. Using generic drugs can help prolong that point compared to using all brand name drugs which can run the bill up much faster.

Drug manufacturers offer prescription assistance programs, and most have developed plans now for Medicare Part D beneficiaries. Investigate these programs particularly if you are on very high priced drugs for renal failure, or drugs to prevent or diminish side effects from chemotherapy.

Investigate your options now to prevent a coverage gap, or to be better prepared to bridge the gap.