Are there ways to avoid the Coverage Gap?

There are ways to effectively delay reaching the Coverage Gap or “donut hole.” You enter the Coverage Gap when your total prescription costs (your deductible and copayments in the initial coverage stage plus what the plan pays) exceed the amount set by Medicare each year. The best way to delay reaching the gap is to keep your pharmacy costs down. Here are some ways you can do this:

  • Use generic medications when available and appropriate for you. Generics cost a fraction of the price of their brand-name counterparts, and many Medicare Part D prescription drug plans (PDP) offer $0 or low copayments when you use a generic medication. Talk to your doctor or call your plan and ask for help in finding lower-cost alternatives for your brand-name medications.
  • Take advantage of a home delivery pharmacy for your long-term medications and use a preferred pharmacy when possible. Choosing a preferred pharmacy helps to lower your costs.

 

Posted on: October 15, 2014
by
Vice President of Medicare Solutions

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