Donut Hole

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What do you do when your loved one reaches the Medicare "donut hole" on medications and cannot afford to buy his meds?

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There are many organizations that can help with med costs. Try the RX Outreach website. It does not matter about whether a person is on Medicare, Medicaid, etc. with this program. Even people who are not old enough for Medicare can get meds at a very reasonable cost.
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I found a company that helped by doing all the paperwork required by the drug companies' assistance programs. As Carol mentioned, it can take some doing to navigate the paperwork, etc that the assistance programs require to qualify so it's a great service to have someone do it for you. It worked for us while in the donut hole; it's worth a shot.
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My friend just nudged me to remind you all that not all pills should be cut in half due to absorption rates and some generics don't provide the same theraputic range - - anything you plan to do please discuss consequences with your doctor. You can't assume that they will remind you. Always ask to be sure.
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be direct with the doctor & ask for samples of the meds that are most expensive every month. Most doctors are on your side & will help if you ask. they want to see their patients stay healthy.
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Hmmm...here might be an idea. Usually double amt. Rx's (ie, 100mg rather than 50) are not more expensive. Mom's doctor did this with Zoloft. Ordered double dose pills and we cut them in half.
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Depending on the drug manufacturer, some have programs for people who have Part D or other prescription drug insurance, especially if the patient is in the gap with Part D. It takes some searching but if you go into the website for the drug you need, find the manufacturer, and go into that site, you will find info to help. If not, call the manfacturer . If have done it and have save enough on my Mother's medications to keep her out of the gap. I just don't understand WHY there is a gap!! I dont know of any other prescription drug coverage that has one. Another way to discrimante against the elderly???
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There is a program called Rx Outreach that you can access online. It lists medications that you can buy at a low cost. You can also find out the name of each drug manufacturer, go online to the manfacturers website and probably find a program to help get the meds. A lot of the manfacturers will still take applications from patients who have Part D if their income is below a certain level. It is time consuming to fill out the apps, get new prescriptions, etc. but since any meds you get from the manufacturer or other programs do not count on the Part D coverage, you can avoid the donut hole. Good luck with this, I have been doing this with my Mothers meds and have been able to avoid the gap and she takes a lot of medicine!
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Here's what happens to my 99-year-old mother with the donut hole. She is in an assisted living facility. They dispense her meds. They use a separate pharmacy entity to maintain her prescriptions, obtain them from (themselves), and they put them in little organizers or packets or something for each day's dosage, etc. They do not have a bargain rate for the prescriptions. She has even had her OTC meds taken from her, and is not allowed to obtain any prescriptions on her own. If she wants to obtain her own prescriptions, she must go get them herself and pay a fee for each prescription to be introduced into their "system" which often exceeds the original price of the prescriptions themselves. Even samples that the doctor tries to give her are confiscated and destroyed. Therefore, she hits the donut hole pretty early in the game. There is no logic to be argued here. This is the way they do it at this place. Everybody gets a piece of her pie. they point out that this was part of the contract she signed when she entered, and that these policies are for her own safety and to protect the staffers. She has nearly run out of her life savings, despite the fact that she never spends a nickel on herself. Monthly resident fee is over $3200. If anyone has some insight on this situation, I'd be glad to hear it. In a separate issue, I have described our life under Home Health, as my husband is a quad. We live hundreds of miles from my mother. I cannot go to or help her. Breaking my heart.
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With Medicare D, once you reach a certain amount on your coverage, there is a time where you must foot the full bill (rather like meeting the deductibles on other health insurance). After that amount is satisfied, then Medicare kicks in again. This "donut hole" is a disaster for many elders with expensive medications that can cost hundreds, if not thousands a month.

There has been an outcry about it, but it has yet to change.
Carol
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I guess I am in the dark on this one.... I do not know what you mean by "donut hole"/ empty prescription fulfillment.
If you have Medicare Part D, it should suffice for all generic and some non-generic medications. Does it not? There is a small $3.00- $8.00 co-pay, but surely that is not your problem, is it?
Some medications are not approved by Medicare Part D, at all, and therefore are deemed unnecessary to your health. For example, Retin A is not allowed by Part D, and therefore must be paid for out-of-pocket. Tell me what you men by this so-called "donut hole".
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