Donut Hole

nagrom · ‎07-03-2010

Yea! I am now officially out of the donut hole. Every other year I experience this. Now for the rest of the year my meds are cheaper. I also try to stock up at the end of the year so next year will not need certain 90 day prescriptions until March.

Does anyone else manage their meds this way too? If we had reasonable prices for our prescriptions like Canada does we would never think of ways to save money like this.

chessylady · ‎05-01-2010

I have Medicare advantage through an HMO. My prescriptions cost $10 out of pocket unless it is not on their formulary.

nagrom · ‎07-03-2010

I have a Medicare advantage plan as well but some of the scripts are costly. For example the Advair diskus runs over $500 for a three month supply. Then there are other things like insulin that run another $423 for one and $250 for another. The test strips run $1.00 per strip and the insurance covers a portion so it runs about $178. Regular scripts could run $10 but it's the other than is so high. Nasal spray runs $38 a month. I could go on......some of my meds are very old but the price has skyrocketed. Humalog is one. You hear about people complaining about the epi pen but the insulin and asthma meds are that and more....a friend has only one kidney and her spleen was removed. Her one med runs $1000 a month. No discount...not all plans cover different type of meds.

hckynut · ‎03-10-2010

Neither Medicare or my Secondary Insurer are involved in my prescriptions. That is a completely separate program from my Medical Insurers. It is paid for as on of my retirement benefits after my 33 years with the company.

They are now all generics(but were not for many years), so the cost is much less. Highest price is $25 for 90 days for 2 of my prescriptions. The others range from $2.25 to $10. It for me is a good program that was much more expensive before the plan switched and promoted mail order 90 day prescriptions.

hckynut(john)

AngelPuppy1 · ‎03-13-2010

@nagrom wrote:
Yea! I am now officially out of the donut hole. Every other year I experience this. Now for the rest of the year my meds are cheaper. I also try to stock up at the end of the year so next year will not need certain 90 day prescriptions until March.

Does anyone else manage their meds this way too? If we had reasonable prices for our prescriptions like Canada does we would never think of ways to save money like this.

@nagrom

Yes, my husband just did this, too; his scripts are atrociously expensive. It's a crime, really.

"A day without sunshine is like, you know, night." - Steve Martin

AngelPuppy1 · ‎03-13-2010

@nagrom wrote:
I have a Medicare advantage plan as well but some of the scripts are costly. For example the Advair diskus runs over $500 for a three month supply. Then there are other things like insulin that run another $423 for one and $250 for another. The test strips run $1.00 per strip and the insurance covers a portion so it runs about $178. Regular scripts could run $10 but it's the other than is so high. Nasal spray runs $38 a month. I could go on......some of my meds are very old but the price has skyrocketed. Humalog is one. You hear about people complaining about the epi pen but the insulin and asthma meds are that and more....a friend has only one kidney and her spleen was removed. Her one med runs $1000 a month. No discount...not all plans cover different type of meds.

@nagrom

Same here. DH has to purchase all of these diabetic supplies and things for his COPD. These things are atrociously over-priced and it makes me so mad! I mean, he has to have these things to survive! You have no choice. So much for the golden years. What gold? They make sure you have not one cent left to your name after you finish paying for all of this cra*p!!!!

"A day without sunshine is like, you know, night." - Steve Martin

gidgetgh · ‎03-09-2010

@nagrom wrote:
Yea! I am now officially out of the donut hole. Every other year I experience this. Now for the rest of the year my meds are cheaper. I also try to stock up at the end of the year so next year will not need certain 90 day prescriptions until March.

Does anyone else manage their meds this way too? If we had reasonable prices for our prescriptions like Canada does we would never think of ways to save money like this.

My husband is out of the doughnut hole also. Yipee!!! Stock up time for us also. He has Parkinson's and his meds are pretty darn expensive, but not when he's out of the dougnut hole. We use mail order for his meds and I refill the minute I'm able to.

Why is it, when I have a 50/50 guess at something, I'm always 100% wrong?

Imadickens · ‎06-15-2016

Help, please. What is the donut hole?

Never underestimate the power of kindness.

nagrom · ‎07-03-2010

The donut hole is a stage of payment when you have paid $3310 for your copays for prescriptions for the year 2016. This is stage 3. The costs of prescriptions then become very costly until you have paid $4850. Then you move out of the donut hole and your meds are very reasonable through the end of the year. Many meds cost 5% in this phase.

Prescription copays are very reasonable for tier 1 and Tier 2 drugs. Tier 3, 4 and 5 meds are very well expensive. I am asthmatic and the inhalers are extremely expensive as are my diabetic insulin and supplies. I am unable to take the cheaper diabetic meds as I have allergic reactions. Thus I was forced to go on insulin. The needles and testing strips are outrageously expensive. For folks like me there is no choice with the meds we are on.

nagrom · ‎07-03-2010

I tried to purchase a meter and test strips from Amazon.com through a Canadian supplier. Cost was very reasonable and I thought it was the way to go until I got an email notice stating the test strips were being recalled. I don't remember why it was recalled but I just had used up all of my order of strips......Now I doubt I will try that again.

My insurance will only cover a certain brand of meters and test strips. I was forced to buy a new meter and test strips. Now I got my 2017 Medicare booklet. My Humalog is no longer in their covered list of prescriptions. When I researched online there are websites stating the same. At this time I cannot find replacement information. I take Humalog for short term and lantus for long term. Other insulin such as levemir and humulin cause reactions and am unable to take them. Will try to find out what will be covered . Grrr