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Hawaii Led Nation in Percentage of Medicare Beneficiaries in Coverage Gap

Thirty-six percent of Hawaii residents enrolled in the Medicare prescription drug program fell into the coverage gap or so-called “doughnut hole” in 2007—the highest percentage in the country. That left about 33,000 beneficiaries on the hook for 100 percent of their drug costs, while still paying premiums.

Nationally, 26 percent of Part D enrollees—some 3.4 million people—fell into the doughnut hole in 2007, according to a Kaiser Family Foundation report. That’s sobering, since, on average, out-of-pocket spending doubles when patients reach the doughnut hole, and many people stop taking or reduce their use of medications as costs rise.

According to 2008 survey of Hawaii residents age 50 and older, women and people with lower household incomes are especially hard hit by rising prescription drug prices. Even before the current economic downturn, one out of ten residents surveyed said they delayed filling a prescription, took a smaller dosage of medication, or cut back on food or utilities to afford the cost of a prescription.

To help address these issues, AARP has launched the AARP Doughnut Hole Calculator, a new online resource to help older Americans avoid the dreaded coverage gap. The calculator guides visitors through their prescription drug options using localized information about their plans and prescriptions to determine if or when they will fall into the coverage gap. In about 15 minutes, visitors can view a graph of their out-of-pocket spending by month, look up lower cost drugs for their conditions, create a Personal Medication Record and print out personalized letters to their doctors to help start a conversation about safely switching prescriptions.

“The coverage gap is expected to widen substantially in coming years, and that means higher out-of-pocket costs for tens of thousands of Hawaii residents,” said AARP Hawaii State Director Barbara Kim Stanton. “With the Doughnut Hole Calculator, people in Medicare now 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.”

As a part of its Health Action Now campaign, AARP is calling on Congress to close the doughnut hole and lower prescription drug prices so that no one has to go without the prescriptions they need to stay healthy. Research has shown that when people cut back on their prescription drugs as costs become unaffordable, that can lead to more serious health conditions and larger health care bills down the line.

The calculator is powered by DestinationRx as part of a special arrangement between AARP and Medicare. The data is the same used by the Medicare Prescription Drug Plan Finder, giving users the most accurate and up-to-date drug pricing information available.

Other Resources

Demand Health Action Now

AARP Government Watch

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