Will You Fall into the 'Doughnut Hole'?

By the end of this summer, more than one million older Americans will have fallen into the “doughnut hole” – a coverage gap in Medicare’s prescription drug program that leaves individuals on the hook for all of their own drug costs while still paying premiums. For many, this amounts to thousands of dollars in unbudgeted spending. To help people avoid the dreaded coverage gap, AARP has developed a new online resource, the AARP Doughnut Hole Calculator, which is free to use.

Stuck in the Doughnut Hole

“Twenty-five percent of Massachusetts residents in Medicare fall into the prescription drug coverage gap each year, and hundreds of thousands more nervously wonder if they will,” said Deborah Banda, AARP Massachusetts state director. “For the first time, people in Medicare have a simple way to figure out if they’ll fall into the doughnut hole, and find ways to potentially avoid it by switching to safe, less expensive medications.”

Research shows: People cut back on their prescription drugs when their costs become unaffordable, which can lead to more serious health conditions and larger health care bills. Nearly 25 percent of people with Medicare drug coverage who have three or more chronic conditions delayed or did not fill a prescription because of high costs.

Health Action Now

AARP believes all Americans should have affordable health care choices, including prescription drugs. As a part of its Health Action Now campaign, AARP is calling on Congress to close the Medicare doughnut hole and lower prescription drug prices so that no one has to go without the prescriptions they need to stay healthy. AARP recently joined President Obama to endorse an agreement by Senate leaders and the pharmaceutical industry that would reduce brand name drug costs by half for most people who fall into the doughnut hole.
 
“Saving money on prescription drugs is going to mean pressing hard in Washington to close the doughnut hole,” Banda said. “We are proud to help announce significant progress toward that goal. In the meantime,” she added, “We also want to give Americans the tools they need to cut their drug costs and stay out of the gap in the first place. We encourage every person in Medicare to take a few minutes to find the right drugs at the lowest prices.”
 

Using the Calculator

AARP’s Doughnut Hole Calculator is easy to use. To get started follow these simple steps:

1. Visit AARP’s Doughnut Hole Calculator

2. Fill in your zip code.

3. List your drugs.

4. List your health plan.

After entering this information, you’ll find out how long your coverage will last before you fall into the doughnut hole. You’ll receive a list of less expensive, but equally effective medications that you can discuss with your doctor. You can even print a letter to your doctor for each medication alternative that may save you money. And don’t worry about privacy – any information you provide stays private and is erased as soon as you exit the calculator.

Find out More

To stay up to date about AARP’s health reform priorities, check back with AARP.org/ma or contact as at ma@aarp.org