5 Ways to Reduce Part D Costs in the Donut Hole

The dreaded Medicare donut hole. We absolutely hate it when our clients find themselves in the donut hole, but unfortunately, sometimes there is no avoiding it. Even so, we’ve still got a few tips to reduce your Part D costs in the donut hole.

1. Switch to Generics

Start by talking with your healthcare provider regarding more economical alternatives (like switching to generics) for treating your condition. Even if your current prescription lacks a generic version, there could be alternative medications with lower costs that effectively address the same condition.

2. Use Preferred Pharmacies

Opt to fill your prescriptions at preferred pharmacies within your Part D drug plan. Many plans include both preferred and standard pharmacies within their network. While all pharmacies in the network are accessible, choosing preferred pharmacies can result in significantly lower costs for your prescriptions.

You may even consider utilizing your prescription drug plan's mail-order service. Medications obtained through mail orders frequently come with reduced overall expenses compared to those purchased at retail pharmacies. Opting for this option can help decrease the amount applied toward your Part D initial coverage limit. Some insurance carriers provide generics at rates as low as $0 when ordered through their designated mail-order program.

3. Research Pharmaceutical Assistance Programs

Explore pharmaceutical assistance programs to alleviate the costs of expensive medications. Both drug manufacturers and state assistance programs may extend support for certain high-cost medications. Additionally, consider looking into charitable organizations such as the National Patient Advocate Foundation, which may provide assistance. Applying for these programs allows you to check if you qualify for significantly reduced copays on the prescribed drugs, with eligibility often contingent on your income.

4. Use Discount Drug Programs

Explore your pharmacy's proprietary drug programs for potential cost savings. Some pharmacies, like Walmart, offer lists of generic medications that you can buy without insurance for a minimal cost, often $4. Purchasing these medications outside your drug plan ensures that they do not contribute to reaching the Medicare donut hole. Develop the practice of consulting with your pharmacist to identify the most economical way to fill each prescribed medication. You may even consider other discount drug programs like GoodRx, Cost Plus Drugs, and others.

5. Apply for Extra Help

Submit an application for Extra Help, a Medicare savings program designed to assist with your drug costs. If eligible, this subsidy can lead to reduced premiums and the elimination of your deductible and coverage gap. Reach out to Social Security at 1-800-772-1213 to get the necessary application for consideration.

Get Help Lowering Your Part D Costs

Get help reducing your Part D costs with the expertise of our licensed agents. Request your complimentary Part D analysis today, and let us guide you in discovering the most effective ways to reduce your Medicare donut hole expenses.