May 11th, 2010 at 1:01 am
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Medicare D “Donut Hole” Calculator Can Help Eliminate Guessing

by Carol Bursack

Ah, Medicare Part D prescription drug coverage. This is one of the most confusing of the Medicare alphabet “parts” to figure out, because as your prescriptions change for health reasons, you may have to change the insurance company that provides Medicare Part D coverage. Not all companies cover all drugs.

To make it even more fun, there is what is called a donut hole in the coverage plan. This is the gap where your insurance stops paying for prescriptions, and you must pay the full price until your hit a target amount.  The donut hole isn’t hard to reach with drug prices as high as they are. Drugs such as Aricept, given for Alzheimer’s disease, can be very expensive. After the gap is covered, the policy takes over and then all you pay is a small co-pay.

This coverage gap is universal with Medicare D policies, no matter what company you chose as a provider, as that is how Medicare D was designed. The new healthcare reform has provisions that will gradually close this gap in coverage, but that will take several years to be fully active.

AARP has a convenient calculator that can help you figure out when you will fall into that coverage gap. You will need to type in your Zip code and have your insurance information and drug information ready. Have the pill bottles handy, as you’ll need to put in dosages and other information. Fill out the form, and you can have an idea of when you will be paying full price for your prescription drugs. The calculator will suggest alternative drugs that may be cheaper.

It’s good to be forewarned, I guess. You can find the Medicare Prescription Drug calculator here.

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