The Doughnut Hole

Jul 23, 2007

  1. arnguy
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    Hey guys and gals, a close relative just met her "doughnut hole" Part D eligibility. She has emphysema and uses lots of meds. She is afrraid to use imported meds. Anyone have any suggestion?
     
    arnguy, Jul 23, 2007
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  2. Cenla Agent
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    I haven't dealt much with this issue in depth but my understanding is that there are now a number of patient assistance programs that help people who end up in the coverage gap. A good resource would be the local council on aging.
     
  3. midwestbroker
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    Depends on the state.

    Missouri has a program (MO RX) that will pay for 1/2 your drugs, but you have to qualify (income based). I know that some other states are doing the same.
     
  4. GreenSky
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    Patient Assistance Programs

    If she is living primarily on social security, she may likely qualify to obtain medication for free from the patient assistance programs.

    Go to www.needymeds.com and see what can be had for free. Some drug companies disqualify you if you have a Part D plan (but how could they check?).

    You must prove your income but your social security awards letter is usually good enough - many seniors don't file income tax anyway.

    Rick
     
    GreenSky, Jul 23, 2007
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  5. policy doctor
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    Depending on her meds, I remember Secure Horizons recommending generics where possible so she could stretch out the time before hitting her "donut" hole.

    Also, if she is on nebulizers, stuff like that, have you tried Liberty supplies? they advertise on tv all the time.

    Last recourse, free meds from dr. office, or at his reduced rate.

    And you can contact the pharma co's direct for patient assistance.

    Have you tried your state SHIP program or call the senior centers/council on aging .

    Let us know what method worked for you.
     
  6. arnguy
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    Thanks for the suggestions guys. BTW aren't there some Part D plans that cover the "doughnut hole?" This is a Pennsylvania case. I will let you know how it is resolved.
     
    arnguy, Jul 24, 2007
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  7. senior-advisor-indiana
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    I believe Sierra is the only one that covers brand and generics. Costs about $108 per month for that plan.
     
  8. arnguy
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    I took a second look at this Nationwide Prescription Help for ALL AGES 1-573-996-3333, a/k/a Free Medicine Foundation that I mentioned in a post a few weeks ago. Allegedly, for a refundable $10 fee for each medication they will get you signed up for free drugs through through pharmaceutical manufacturers' plans. They supposedly will refund the $10 for each med with which they are unable to sign you up.

    Well, I checked with the BBB and found that this outfit has an unsatisfactory rating because of unresolved issues with their customers such as refunds, etc. Furthermore, BBB takes issue with them calling themselves a "foundation." Foundations are non-profit organizations that are Internal Revenue Code Sec. 501(c)(3) tax exempt organizations. What made me suspicious is that they use ".com" rather than ".org," although the ".org" is not a guarantee of a legitimate non-profit organization. They are located in Doniphan, MO.:mad:
     
    Last edited: Jul 25, 2007
    arnguy, Jul 25, 2007
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  9. arnguy
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    Thanks for the information, SAI. You are correct, there is coverage during the gap by Sierra. In PA, the cost is $104.50 a month; however there is a fly in the ointment. She is in a MA plan (Aetna) and cannot have a separate Part D. Maybe when open enrollment rolls around, I can talk her into a Med Supp with a Sierra Part D.
     
    arnguy, Jul 25, 2007
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  10. senior-advisor-indiana
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    Sounds good. Glad I could add some substance. Some here think I have nothing to offer.
     
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