There is a term that senior citizens are becoming familiar with. It's called "the donut hole.” In real English it means you have exhausted your Medicare Part D prescription drug coverage and all of your medication costs come out of your own wallet. True, this isn't a problem for everyone — just those who rely on Medicare Part D to pay for prescription drugs.
Here's how it works.
The maximum amount Medicare Part D covers is $2,510. When the medication costs exceed that amount, patients are forced to pay out-of-pocket. Those patients who exhaust their insurance in less than 12 months, fall into "the donut hole.”
Well, now that they have "fallen in," how do they get out? They spend $4,050 out of their own pocket. Only after they have spent this amount will their insurance kick in again. This time, I'm happy to report, the insurance considers your case to be "catastrophic" and 95 percent of the cost of your medications will be covered, but only up to December 31 of that year. Then the donut hole game starts all over on January 1.
The good news is that there is help for people who have fallen into the donut hole. It's called Serving Our Seniors' Drug Repository. The medicines in the drug repository have been donated by institutional pharmacies and are to be used to help people with no prescription insurance or those who have it, but can't afford the high deductible or co-payments. Patients pay $7.40 per prescription.
Call our office for more information at 419-624-1856 or 1-800-564-1856 and ask to speak with someone (other than me) about using the drug repository.
Also don't forget to come to the upcoming forum, “Consumers Beware: Understanding Equity Indexed Annuities & Life insurance Scams,” from 2-4 p.m. Aug. 19 at the Erie County Service Center, 2900 Columbus Ave., next to the fairgrounds.
Attorney, Robert Smith from the Ohio Department of Insurance fraud division will be giving the presentation.