Monday, October 23, 2006

Suggestions for minimizing your drug costs...

For those of you who have medicare prescription drug coverage, or know someone who does, this one's for you. answers a question from a reader who states she's reached the "doughnut hole" (the first threshold for medicare part D which is $2,250) and would like to know how to keep costs down after that. Medicare part D covers most of your drug costs up to $2,250. That includes deductibles, your co-pay, and the insurer's share of the cost. After that, you hit the "doughnut hole" or the coverage gap. After that you'll have to pay 100% of the cost of your drug bills until your total out of pocket goes to $3,600. Then the plan will cover 95% of your bills. The "doughnut hole" thresholds will be $2,400 and $3,850 by next year. To help minimize your out of pocket money between the thresholds....
  • Ask your doctor about generics. You can save money in the doughnut hole and get better coverage within your plan beforehand. Many plans, for example, charge only a $5 co-pay for preferred generic drugs but increase the co-pay to $30 for preferred brand-name drugs, or $60 for non-preferred brand name drugs until the total drug costs reach $2,250. And most plans that provide coverage in the doughnut hole cover only only generic drugs while in the coverage gap and require you to pay the full price for everything else.
  • Try different medications. Even if your drug doesn't have a generic equivalent, another medication that treats the same condition could cut your costs. If your plan has enlisted PartDOptimizer (several of the big Part D plans are included), you can compare the costs for similar drugs. Ask your doctor if you can safely switch drugs.
  • Buy in bulk. Many plans give you a discount if you buy a three-month supply of drugs at once.
  • Find a cheaper pharmacy. Wal-Mart and Target have announced that they will sell many generic drugs for $4. Your plan also may offer special discounts for preferred mail-order pharmacies. Also, check, which compares drug prices at various pharmacies. Make sure these pharmacies are included in your Part D network. Otherwise, the purchase may not count toward reaching the end of the doughnut hole.
  • Consider Canada. Buying drugs from Canada doesn't count toward the $3,600 to reach the end of the coverage gap, but it can lower your drug costs. Two new rules have eased the restrictions on drug imports. Americans now can carry a 90-day supply of drugs from Canada without being stopped by customs agents. And government officials recently announced that they will no longer seize mail-order prescription drugs from Canada.
  • Get help. If your income is below a certain level, you can get extra help paying for your prescription drugs. For more information, see Bridging the Coverage Gap at Also see the resources at the Medicare Rights Center's Help Paying For Prescription Drugs.
The open enrollment for 2007 plans runs from November 15 to December 31.


GolbGuru said...

I appreciate the information that you have posted, but I would like to see one more in the list for "suggestions for minimizing your drug cost" and that is eat in moderation, eat healthy and exercise regularly early on in your life to avoid problems later.

Btw, that allowing drugs from Canada thing was really good. When they last aired a PBS documentary on the subject, I was almost certain that drug companies will have lawmakers ban the thing.

John said...

That's a good point. That is of course the MOST important thing anyone can do.