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(HealthNewsDigest.com)-The “doughnut hole,” a term coined to describe the gap in Medicare Part D prescription coverage, continues to raise concerns for enrollees. According to the Kaiser Foundation, as many as 14 percent of enrollees fall into the gap, which occurs when a person’s prescription costs reach $2,700. Coverage resumes when out of pocket spending reaches $4,350. This gap puts a financial strain on seniors who typically take numerous medications. However, by reviewing medications and plans each year, there may be opportunities to avoid the doughnut hole. In fact, recent analysis by CVS/pharmacy and the National Council on Aging shows that consumers could potentially save an average of $612 on their prescriptions by switching their plans. With the annual enrollment period for Medicare Part D underway November 15 through December 31, now is the time to take inventory.
“It’s critical that patients become proactive in saving money on prescriptions,” says Wendy Zenker, vice president of the National Council on Aging Benefits Access Group. “We see more people lose opportunities to save because they just don’t invest the time each year to review their plan selection and ask for help.”
Here are some tips to get you started:
Review Your Current Medications
CVS pharmacist Brian Berninger recommends first asking your local pharmacist for ways to save on your current medication regimen. “We see a lot of scenarios where patients can often switch to a generic-new generic drugs are approved all the time and often doctors aren’t aware,” he says. “Patients can also consolidate multiple pills into one, or opt for a more affordable over-the-counter alternative. If prescription costs are lowered in advance of selecting a Medicare Part D plan, it can help in choosing the most affordable plan and potentially avoiding the doughnut hole.”
Consider Total Cost
When selecting a plan, it’s important to evaluate how much in total you pay each month for prescriptions-the premiums for insurance plans as well as other costs, such as deductibles and co-pays.
Why Review Each Year?
Each year insurance plans change, including premiums, co-pays and the list of covered drugs. Your own prescription needs change as well. Reviewing plans against one another can be confusing, but free online tools like the Medicare Part D Calculator found at www.cvs.com/medicare can help. This tool evaluates your medications against Medicare Part D plans available in your region, and it compares projected total annual costs. CVS/pharmacy found that consumers who compared plans with the tool last year could save an average of $612 if they switched their plans.
“It’s in consumers’ best interests to review their prescription drug coverage each year,” adds Zenker. Pharmacist Berninger encourages “all enrollees to talk with their pharmacists and use available tools like the CVS/pharmacy Prescription Code and Part D Savings Calculator during the annual enrollment period.”
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