How to Avoid the Medicare Doughnut Hole

Many seniors find the Medicare Part D coverage gap, or "doughnut hole," taking a toll on their wallets. As of 2011, when you spend $2,840 on covered prescription drugs through Part D, you enter the doughnut hole. While in the hole, you are required to pay for prescriptions out of pocket until your out-of-pocket costs reach $4,550. Afterward, Medicare coverage resumes. You do not have to fall into the coverage gap. Take preventative action early to avoid expenses down the road.

Instructions

• 1

  Track your spending. Keep records of all prescriptions costs covered by Medicare. Knowing when you are on the verge of reaching the doughnut hole can eliminate surprises and unplanned costs.

• 2

  Switch to generic medications. Requesting the generic form will delay your reaching the gap. Talk to your doctor to discuss options.

• 3

  Ask for samples. Many doctors have samples on hand. Sampling the prescription allows you to see how your body will react before incurring the expense. If it is not for you, no money is wasted.

• 4

  Utilize free prescriptions. Some pharmacies offer free or reduced-cost medications. For example, Shop Rite offers certain antibiotics and diabetes medication free of charge. Anyone can participate in the program.

• 5

  Apply for assistance through the Extra Help program. Medicare and Social Security teamed up to implement Extra Help for individuals with limited income and resources. If the doughnut hole is unavoidable, the program can lessen the financial burden by covering a portion of prescription drug costs. Visit your local Social Security Administration office to apply.

• 6

  Maintain supplemental insurance coverage. Private insurance policies may fill in the coverage gap. If you have prescription drug coverage through employment, the employer or union is required to notify you if your drug coverage is creditable. The policy may not offer benefits once you choose a Medicare drug plan.