Medicare Part D has been a blessing for so many senior citizens who may be on a fixed income and have a limited budget to spend on prescription medications. For those seniors who have a lasting condition, it can be very difficult when they hit the Medicare Part D coverage gap. At this time of year you hear a lot of talk about the donut hole or coverage gap. How does it work, what is it, and why is it there? How does it provide prescription drug help?
The coverage gap (donut hole) was created to reduce the cost of Medicare’s Part D coverage. Each year, a limit for Part D is determined. 00 was the 2007 yearly amount. The annual amount was increased in 2008 to 10. In 2009 the limit is ,700. determination of the limit is based on the total cost of the drugs that you receive. This includes what the insurance company pays and your co-pays. For example, if a medication is priced at 0 and the insurance company pays 0 and the recipient pays , the amount that goes towards the yearly limit is the full 0
During the time you are in the donut hole or coverage gap, you must pay for the cost all of your prescription drugs. There is coverage for your generics when you are in the donut hole or coverage gap. The cost of most generics is so low that the benefit of having them covered by a plan is not that great of a benefit. Everyone’s situation varies so for some patients it might be worth it to have coverage for their generics.
In just a few short months a Medicare Part D person with chronic health problems can reach the donut hole or coverage gap due to their expensive prescription drugs. We have seen patients reach the coverage gap as soon as February. Steering people to use less costly medications when possible is the whole point for the donut hole. This punishes those people who must take expensive medications because nothing else works.
People with rheumatoid arthritis can fall into the coverage gap within two or three months because of the price of Enbrel. The option at this point is to pay for the prescription drug at full price for several months until the catastrophic coverage portion applies or suffer the potentially disabling consequences of stopping their prescription medication. The cost of Enbrel is approximately ,000 annually. There are a lot of senior citizens who are unable to afford for that.
Due to their lower income level, some patients will be able to qualify for patient assistance programs.
Going directly to the manufacturer can be most helpful in getting low or no cost drugs. Contact the company and ask about their Prescription Assistance Program. Almost all pharmaceutical companies offer such programs, which enable people to receive drugs they need at a price they can afford (often for free). You and your physician will need to complete an application. Patient Assistance Programs run by drug companies have been in existence for over 20 years. These programs are designed to assist eligible patients who can’t afford their prescription drugs due to limited income or other financial hardships. Drug companies did not want their low income patients to be forced to make a choice between paying for life saving prescription drugs or for paying for rent or groceries. As a result, patient assistance programs came into being as part of the company’s philanthropic efforts. Until relatively recently, few people knew about these programs or could follow the complicated application process that was required for participation. Often times multiple applications had to be filed. Please do your research and get the help with prescriptions that you need.
Tags: free medicine, help with prescriptions, pap, prescription assistance, prescription help, rx help