Doughnut Hole Calculator Helps Medicare Beneficiaries Reduce Out-of-Pocket Costs

What is the "doughnut hole" calculator?

AARP has developed an on-line tool to help you see if you are nearing Medicare Part D’s coverage gap, or "doughnut hole." The calculator can also help identify less expensive, therapeutically similar drugs, and check if you qualify for Medicare's Extra Help.
 
How do I use the calculator?

It’s easy to use. Go to the doughnut hole calculator, fill in your zip code, click on your health plan, list your drugs. For a quick preview of the calculator, take the step-by-step calculator video tour at the bottom of the webpage.

This new, interactive, online tool can help Nevadans reduce their spending on medications by identifying safe, effective alternatives, such as generic drugs or therapeutically similar drugs which could help to postpone or avoid the doughnut hole entirely.

Even those not likely to hit the doughnut hole might save money, because the tool gives everyone options to lower out-of-pocket drug costs.

The calculator also allows you to print a letter—in English and in Spanish—you can give to your doctor for each medication alternative that may save you money.

Your personal information stays private too. In fact, your personal information is deleted from the system as soon as you exit the calculator.

Tell me more about the “doughnut hole”

The term “doughnut hole” refers to a gap in coverage in the Medicare Part D Prescription Drug benefit. Essentially, Medicare Rx drug coverage is divided into three phases.

Phase 1: You may pay a deductible and about 25% of your Rx drug costs until your total drug costs (including the amount your plan has paid) reach the maximum benefit of $2,700.*

Phase 2: The “Doughnut Hole.” You pay 100% of your prescription drug costs until you have paid a total of $4,350* in drug costs.

Phase 3: Catastrophic Coverage. You pay 5% of your total drug costs and your plan pays the rest.

*2009 cost thresholds reflected

Why is this important now?

In Nevada, 12% of people in Medicare Part D fell into the doughnut hole in 2007 and many more would prefer to reduce their out-of-pocket prescription drug costs.

Summer is a time of year when many people using the Medicare Part D prescription drug benefit fall into the “doughnut hole.” AARP has developed the doughnut hole calculator to help you, your loved ones and friends stay out of the coverage gap.

“AARP believes health reform must help those with the highest drug costs save money by closing the doughnut hole and lower drug costs by giving people greater access to generic drugs,” says Barry Gold, director of government relations.

Other Resources

Governor’s Office for Consumer Health Assistance
Pharmacy Assistance programs

State Health Insurance Advisory Program (SHIP)
Free information, counseling and assistance to Medicare Beneficiaries in Nevada

AARP Bulletin Story

AARP Nevada Rx Drug Brochure