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Coverage gap

Avoid the Medicare 'doughnut hole'

September 7, 2009
Lyle Halvorson

This year, more than 19,000 older North Dakotans will have fallen into the "doughnut hole" a coverage gap in Medicare's prescription drug program that leaves individuals on the hook for all of their own drug costs while still paying premiums. AARP has launched a new online resource to help more than one million older Americans avoid this dreaded coverage gap.

The AARP Doughnut Hole Calculator, available at (www.aarp.org/doughnuthole), guides visitors through their prescription drug options using localized information about their plans and prescriptions to determine if or when they will fall into the coverage gap. In about 15 minutes, visitors can view a graph of their out-of-pocket spending by month, look up lower cost drugs for their conditions, create a Personal Medication Record and print out personalized letters to their doctors to help start a conversation about safely switching to lower-cost prescriptions.

"One in three North Dakota residents in Medicare fall into the gap each year, and thousands more nervously wonder if they might fall in," said Janis Cheney, AARP state director. "For the first time, people in Medicare have a simple way to learn if they'll fall into the doughnut hole and find ways to avoid it by switching to safe, less expensive medications."

Article Photos

Halvorson

As a part of its Health Action Now campaign, AARP is calling on Congress to close the doughnut hole and lower prescription drug prices so that no one has to go without the prescriptions they need to stay healthy. Research has shown 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.

"Saving money on prescription drugs is going to mean pressing hard in Washington to close the doughnut hole as part of health care reform," Cheney said. "In the meantime, we want to give people the tools they need to cut their drug costs and stay out of the gap in the first place. We encourage every person in Medicare to take a few minutes to find the right drugs at the lowest prices."

The calculator is powered by DestinationRx as part of a special arrangement between AARP and Medicare. The data is the same used by the Medicare Prescription Drug Plan Finder, giving users the most accurate and up-to-date drug pricing information available.

The next open enrollment period for the Medicare prescription drug program begins Nov. 15 and ends Dec. 31. Information and enrollment sessions are being planned across the state beginning Nov. 16. For information, call the State Health Insurance Counseling Program toll-free at 888-575-6611.

For more details on AARP's health reform priorities, visit (www.HealthActionNow.org).

Lyle Halvorson, of Bismarck, is associate director of AARP North Dakota.

 
 

 

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