A new study is out which finds the obvious: many seniors who fall into the Medicare Part D coverage gap known as the “Donut Hole” simply stop taking their prescription drugs, even when they desperately need those drugs to keep their hearts healthy. The study Of the seniors studied who hit the Medicare Part D “donut hole,” those who didn’t have additional financial assistance (i.e. other insurance which covered their prescription drugs) were 57% more likely to stop taking their prescription drugs altogether than those who had other financial resources.
Even worse, most of these seniors giving up on their meds had high blood pressure (hypertension), and about one-third had congestive heart failure. Although the researchers didn’t find any immediate difference in the death rate or health outcomes between the groups during the four month study, they noted that it is unclear how stopping heart, cholesterol or blood pressure medications might affect long-term health outcomes.
The Medicare Part D “donut hole” is the coverage gap which limits how much Medicare Part D will cover for prescription drugs. Currently, the Medicare Part D coverage gap starts when you hit $2,930 in prescription drug costs. Medicare Part D coverage picks up again once you hit $6,657 in drug costs. In between those two points, you’re in the “donut hole.”
Yowza! But I Still Can’t Pay for My Meds!
Well, keep in mind that study was done on seniors in 2006 and 2007. Things are a little better in the Medicare Part D “donut hole” since then. At that time, pre-Obamacare, seniors were usually stuck trying to cover the entire prescription drug coverage on their own, but Obamacare closes that gap over the next few years. Currently under Obamacare, Medicare Part D plan members receive a 50% discount on their brand name drugs while they are in the “donut hole.” Generic prescription drugs are discounted in the Medicare Part D “donut hole” as well. In 2012, generic drugs are discounted 14% in the “donut hole.”
But if the Medicare Part D “donut hole” discounts still aren’t enough help, please talk to your doctor about your predicament. Once your doctor knows about your situation, he or she can look at cheaper alternative medicines or prioritizing the medication that you’re taking to make sure that you can still take the meds that are most essential to your health. We know it’s not a comfortable conversation to have, but unless your doctor knows that you may have to give up taking your meds, he or she won’t know to help you figure out a safer alternative.
Have you fallen into the Medicare Part D “donut hole”? Tell us about it in our Medicare discussion forum!
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