Everyone knows that donuts are not health food. They may taste good, but they’re mostly empty calories–sugar, fat and white flour. Only the hole is non-fattening.
Millions of senior citizens are now sampling a different kind of donut hole. This donut has no flavor, but the main side effect is an empty wallet.
Medicare Part D provides prescription drug coverage, up to a point. This year, once a recipient’s total drug bill tops $2,700, Medicare stops picking up any part of the tab until the total hits $6,154. In that so-called donut hole, every penny for prescription drugs rung up at the pharmacy comes out of the customer’s own pocket. This can pose a real hardship for anyone on a fixed income.
This is the time of year that many seniors begin to experience the sticker shock of the donut hole. They discover how much their medicine actually costs. Up to that point they were paying no more than 25 percent.
Take a hypothetical example, Mr. Sanchez. He is 68 and takes Advair for asthma, Actos for diabetes, Nexium for acid reflux and Flomax for prostate enlargement. A few months ago his monthly bill was steep but almost affordable at around $180 per month. Once he got into the donut hole, however, he had to fork over more than $700 each month.
Mr. Sanchez is taking pricey prescriptions, but he is not unique. The pharmaceutical industry has been raising prices on some of the most popular medicines, perhaps in anticipation of a health care reform bill. This makes it difficult for a lot of people to afford their medicines.
Those with really expensive medications may emerge from the Medicare donut hole. Once the total drug bill for this year tops $6,154, the government picks up 95 percent of the tab.
In the meantime, some patients are having trouble taking needed medicines as the doctor prescribed. They’ve cut back or failed to fill prescriptions.
In a case described in The New York Times, a heart attack survivor could not afford to fill a prescription for Plavix, a medicine that prevents blood clots. The co-pay was unaffordable at $160. He suffered a third heart attack a few months later.
Some patients wonder if Canada is the answer: “How reliable are drugs from Canada? My husband has Alzheimer’s disease and diabetes and takes many drugs. We are in the donut hole and I am considering mail-order drugs. Good idea or big mistake?”
The answer depends on the shopper’s vigilance. Not all online pharmacies are reliable. Some that claim to be Canadian are not. Drugs bought from international online pharmacies (Canadian or other) do not count towards getting out of the donut hole.
But for those who don’t anticipate getting through the donut hole this year, buying from a legitimate Canadian pharmacy may be an option. We have prepared a new Guide to Saving Money on Medicine that describes how to evaluate online pharmacies, offers tips on finding free medicine and tells how to use generic drugs wisely.