Donut Hole????

[sunshine12]

They said it would take about 6 months for most to get to the donut hole with Medicare. I just got a letter saying I have about $560.00 to go before I am there too.
Then we have to pay for all our meds. Now I know I can't afford my meds and there must be other out there also that can't. What are we to do just wait for our bodies to fold up without all our meds?
What is everyone doing? Is there any help for this, or do we just die?

[1sunny1]

I think you need to get part d which is a supplemental insurance.

Sunny

[Madalot]

Part D is what the original poster is referring to. Part D has that donut hole that many people end up in.

The first year I had Part D, I ended up in the donut hole too. I discussed my medications with my doctor and made some changes to switch to generics where possible. I had to supplement one of my premium medications with a generic AND an OTC medication, but with my doctor's approval, that's what I did. For me, it solved my donut hole problem.

I found this year that I was still on one premium medication and I again got concerned about ending up in the donut hole. I discussed it with my doctor to find out if I really needed it. He agreed to let me stop it (for now) and if my condition worsened, we would revisit the situation and decide if there was another, generic medication that would work rather than using the premium, very expensive medications.

I find that if I'm honest with my doctors about my insurance plan and my needs, they do whatever they can to work with me.

[sunshine12]

Thank you for your input. I have everything that is generic already. unfortunately my things aren't generic. I have Diabetes, and heart meds like blood thinners that have no generics. Because people said just go pay for the meds and don't put them on your insurance. They are pretty expensieve also and I cannot afford them.
If it was just one or two I am sure my Doc would give me the samples, but it is all of them and I am also sure people are asking their Docs for samples already that need them that have no insurance.
This is just crazy to have to worry about this. I have no answers here which is why I posted to see if there was any hope.
Having your health means everything today....

[Madalot]

Sunshine --

I definitely feel for you. I was hoping that perhaps you were on a few premium medications and switching to generics would help you.

I know what you mean about paying for the meds out of pocket. I looked into that at one point when I was in the hole. I was going to fill one (a generic no less) and not run it through the insurance. If it went through insurance, my co-pay was $10 and the insurance paid $4. If I paid for it outright, the total cost was $85!!

I think a lot of people do not realize the prescriptions work the same way as doctor/hospital appointments. Pharmacies contract with the insurance companies for a price that is lower than what a person without insurance ends up paying.

I'm sorry this is such a problem for you. Like you, I have a lot of medical problems and take a lot of prescriptions. For me, mine is still workable within the limits of part D -- for now anyway.

I hope you can find a solution.