By the end of this summer, more than one million older Americans will have fallen into what health care advocates call the “doughnut hole,” meaning that they won’t be covered by Medicare’s prescription drug program and have to pay out of pocket.
AARP South Carolina’s Patrick Cobb says his organization has launched a new resource to help older citizens avoid that gap. “The online calculator tells you ahead of time if you’re going to fall into the hole. And it offers advice so you can avoid hitting the gap. The gap is between $2700 and $4300, and those whose drugs have cost enough end up paying out-of-pocket, even though they are also paying a premium for drug coverage.”
The Doughnut Hole Calculator is available at www.aarp.org/doughnuthole, or you may call toll free 1-888-our-aarp.
Cobb says the AARP site compares expensive drugs with less expensive drugs to help a patient find a less expensive way. Viewers will see a graph that displays their out-of-pocket spending by month. Or you may also talk with your doctor or pharmacist and explain your problem.
Cobb says in South Carolina, 30 percent of Part D Medicare recipients fall into the hole, meaning that their coverage stops paying when their drug bill reaches $2700. “When you fall in the hole you’re paying 100 percent of drug costs, meaning if your prescription costs $80, that’s what you’re paying, every time. A lot of patients are hitting the hole in March, April, May or June, because their drugs are that high.”
AARP is calling on Congress to close the doughnut hole and lower prescription drug prices so that no one has to go without the drugs they need to stay healthy. Research has shown that 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.