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Victims of Medicare Part D’s Dreaded Doughnut Hole Have Another Way
By
Stephen Baetge
Editor
Many
seniors who have signed
up for the Medicare Prescription
Drug Plan are shocked to
find out that they are
already hitting the dreaded
gap in coverage known as
the doughnut hole.
During this gap in coverage (between $2,250 and $5,100) in prescription drug
spending, Medicare Part D participants lose coverage, must continue to pay their
monthly premiums and are 100-percent responsible for paying for their medications
themselves. Once they hit the doughnut hole, this massive jump in monthly medication
expenditures makes it very difficult for some Plan D participants to cope financially.
In a recent “Business Week” article, Bruce Stuart, Director of the
Peter Lamy Center on Drug Therapy & Aging at the University of Maryland,
estimated that about 38-percent of Medicare beneficiaries are at risk of hitting
the doughnut hole this year.
This estimation means that seven out of ten million participants could hit the
doughnut hole and lose coverage for part of this year.
“Seniors were expecting to receive a benefit that would help them save
money all year long, and now they are getting slapped with massive monthly medication
bills part way through the year,” says Jeff Uhl, President of Universal
Drugstore, a Canadian mail-order pharmacy.
“Our customers are really angry about having to pay full U.S. retail price
once they hit the doughnut hole and they are rushing back. People are realizing
that they can save much more filling their prescription with our pharmacy when
they hit that point.”
At an average savings of 42-percent less than U.S. retail prices, individuals
can find substantial savings filling their prescriptions at a licensed Canadian
pharmacy once they reach the doughnut hole.
The $2,850 worth of medications that individuals have to pay for personally while
in the coverage gap would cost an average of 42-percent less in Canada. That
means that instead of paying $2,850 for their medications while in the doughnut
hole, an individual could purchase the exact same medications in Canada for about
$1,650.
As an example, someone ordering Lipitor 20mg through their Medicare Part D plan
while in the doughnut hole would have to shell out $348 dollars for a 90-day
supply. The same 90-day supply of Lipitor 20 mg is a much more reasonable $195
at Universal Drugstore. That is a savings of $153 dollars, or 44-percent less.
“U.S. seniors need to be told about this option,” Uhl urges. “Seniors
who hit the doughnut hole and are not going to spend enough to come out on the
other side of the are being duped if they buy their drugs through their Medicare
plan while experiencing this gap in coverage.”
“By purchasing their medications from Canada, while they are in the doughnut
hole these individuals can truly maximize their savings.”
A recent Los Angeles Times article reported that the gap in coverage could change
next year to between $2,400 and $5,451. This would mean an even bigger gap in
coverage next year and therefore more money out of Part D participants’ pockets.
How big the coverage gap will grow in future years can only be speculated.
Although purchases at Canadian pharmacies do not count toward an individual’s
out-of-pocked expenses, Medicare Part D participants may want to consider using
a Canadian pharmacy.
Purchasing prescription medications from a licensed Canadian pharmacy, when the
right situation arises, can provide substantial savings to seniors. Some people
suggest that seniors use a Canadian pharmacy when a drug is not covered by their
plan or when they reach the $2,850 gap in coverage but will not spend enough
to reach the other side of the doughnut hole where they can take advantage of
the catastrophic coverage portion of Part D.
With all the confusion with Medicare Part D plans, it is difficult for seniors
to know what their best course of action is. For many Medicare-eligible individuals
using a Canadian pharmacy as part of their annual prescription drug purchasing
game plan is something they should seriously consider.
This page and its contents ©2006
Metropolitan News Company, Inc.
