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What is a “Doughnut Hole” Anyway?
Medicare drug coverage is generally divided into three phases.
- Depending on your plan, in the first phase—the initial coverage period—you may pay a deductible and about 25 percent of your drug costs.
- In between the first phase and the third phase, there is a gap in coverage, commonly referred to as the “doughnut hole”) when most people must pay all of their medication costs.
- In the third phase—the catastrophic coverage—you pay about 5 percent.
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AARP’s New Easy- to-Use Doughnut Hole Tool
By: State: Nebraska | Source: AARP.org
Summer is a time of year when many people in Medicare Part D fall into the “doughnut hole,” a coverage gap that leaves individuals on the hook for all of their own drug costs while still paying premiums. AARP has developed a new online resource to help you or your loved ones avoid this dreaded coverage gap.
The AARP Doughnut Hole Calculator guides you through your prescription drug options using localized information about your plan and prescriptions to determine if or when you will fall into the coverage gap. In about 15 minutes, you can view a graph of your out-of-pocket spending by month, look up lower cost drugs for your conditions, create a Personal Medication Record and print out personalized letters to your doctors to help start a conversation about safely switching prescriptions.
“Thirty-three percent of Nebraskans in Medicare fall into the gap each year, while many more nervously wonder if they might fall in,” said AARP State Director Connie Benjamin. “For the first time, people in Medicare have a simple way to learn if they’ll fall into the doughnut hole and find ways to avoid it by switching to safe, less expensive medications.”
And, even if you don’t hit the doughnut hole, the tool can give you options to lower your out of pocket drug costs.
It is easy to use. Fill in your zip code, click on your health plan, list your drugs. The calculator will tell you how long your coverage will last before you will hit the doughnut hole. You will receive a list of lower cost medications. 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.
More good news? Any information stays private! In fact, it goes away as soon as you exit the calculator.
So go to the tool and see how much money you can save.
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