- Once you exceed the initial coverage limit porvided by Medicare on perscription drugs purchased, you enter the Medicare Donut Hole.
- The initial perscription drug coverage you receive from Medicare amounts to $1,800 out of the first $2,700 you spend on prescription drugs (can vary if you are in a Medicare approved HMO).
- Once you exceed the initial coverage limit of $2,700, you are on the hook for the next $4,350 of drugs you consume. Put it this way. If you consume around $7,050 worth of prescription drugs a year, you can expect to pay for all of that amount less $1,800. Or, $5,250 right out of your pocket.
Ask the next baby boomer you see if they understand how the Medicare prescription drug program works. Unless they have a relative in the donut hole, I'll bet you a doughnut they can't tell you how it works.
My mother, as many of you already know, goes into the Medicare Donut Hole. As a result, I am always researching ways to cut costs on our purchases of prescription drugs.
Last month, I asked our personal care physician if we could switch my mother from Felodipine to the generic version of Norvasc. He answered yes, and asked me why? I told him that it just dawned on me that Norvasc had gone generic; and that, it was probably cheaper than Felodipine. He told me to research the costs and if it made sense we would make the change.
Here is the math. Felodipine cost us $62.09 a month once we get doughnutted. The generic version of Norvasc, amlodipine besylate, will only cost us $10.03 a month. So, we would save $624.72 a year by making the change.
Last year we went into the donut hole by a little over $1900. It would have been worse if we hadn't received almost $1900 in free samples from our doctor (Aricept, Namenda, Benicar).
The news could be getting better. Today, I found out we are cutting my mother's use of Benicar in half (HCT, 40-25). Like most astute prescription drug users, I know I can continue buying the big one and cut it in half. Sooner or later most senior citizens become pill cutters. Wonderful little machine.
Benicar runs about $72 a month after you get into the donut hole. Before you get in the hole, it has a $30 co-pay (last year $25). We only spent about $310 last year on Benicar (thanks Doc). My best guess is we might not spend anything on Benicar this year. Yehaa.
Ok, here is the recap. We are saving $624.72 on the switch from Felodipine to generic Norvasc. We will likely save $310 on Benicar. Total savings so far $934.72 (estimate).
I'll do my best to get us out of the Medicare Donut Hole this year. I am open to suggestions and ideas. Any doctor's looking for a husband (uh, that is any woman doctors)?
Here is my advice to you. Ask your Doctor if there are alternatives to the prescription drugs you are taking. Or, jump on the Internet and do some research of your own.
If you have an bright ideas, put them in the comments section of this article. If you have any questions, do likewise. We will do our best to come up with answers.
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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,300 articles with more than 9,000 links on the Internet. Bob resides in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room
