What's in a donut hole?

Sue Daugherty
Mar 23, 2010

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.

Comments

Anonymous

Good blog until the (other then me) part.
Does this mean your to busy with politics and don't want to be bothered?

Anonymous

Jeff-

I can answer that one. "Not me" means there is competent, caring staff employed at Serving Our Seniors who will speak with the people who call the agency about this concern--or any other. That's where their job responsibilities lie and they do it very well.

Anonymous

How about those that are married with children? Life is hard for those under 50. Our seniors knew a better economy & standard of living - I'm tired of giving.

Anonymous

Keep calling Medicare and asking different people the same questions until you find the person that really knows what's going on, and who can really help you. Just because someone answers the phone and answers your question doesn't mean they know what they are talking about. Trust me on that one...

Gulliver

TO JEFF, Thanks for the feedback. Allow me to explain. Currently, I get messages to call older adults with questions that could have been answered right away if they would have known not to ask for me, but one of my co-workers. I don't know the minutia as well as they do. I learn from them!! Then I write about it.

It's not that I am opposed to anwering calls, but my co-workers are much better at the details -- more efficient at helping -- because they work with it day in and day out. I don't.

My point is, senior citizens will get better service if they ask for Nancy, Kristen, or Kevin. This is their area of expertise -- not mine.

Hope that helps. Again, thank you for the constructive criticism. Communication is such an art. I'm still trying to master it. -- Sue

Anonymous

Economics is hard on all of us right now. If you're in your 50's or still have children at home, you always have the ugly option on picking up additional jobs. Might not like the pay or hours, but it's more available than if you were Medicare age. You too, will be that age some day, and it's not going to get any better.

Anonymous

People by & large over 50 have had a better economy. History & my relatives prove it. Granted not all had it easy, though back then if you wanted to work anywhere USA there was work that paid real wages. This brings me to my point. In America those over 50 are going to have to share some burdens. Or talk to those that are 20 some thing & realize that they have it harder than you did.

Gulliver

TO DOUG: If you and/or your family have no prescription drug coverage you do qualify to use Serving Our Seniors Drug Repository. We have been blessed with numerous donations. More medications than are being consumed by the senior citizen population.

The medications that commonly treat conditions of those who live in institutions (aka nursing homes) are what we have in stock. This is because our donor is an "Institutional Pharmacies". (That means the pharmacy is specialized in packaging medications used by institutions. That population is predominently elderly). -- Sue

Anonymous

Are many Americans inclusive of numerous Ohioans spoiled rotten whiney children?

Personally last week, I noticed that the Huron Co. Fair and the river festivals in Vermillion and Lorain appeared to be very well attended. I attended the Fair and drove by the festivals.

Nationally to date, the new Batman movie has taken in almost a half billion dollars.

I thought that Bush had ruined the economy and people had no jobs or money?

What time does the Water St. soup queue and the Market St. bread line open?

Rick Studer

TO: Expletive deleted

These BLOGS are so fun because they are like fishing holes stocked with idiots. This particular topic has been pretty quiet but I think I might have caught a whopper.

First off ED, I had to read your post several times to actually understand what you were trying to say. Even invoking the use of my secret vocabulary decoder ring; to make sure I didn’t miss any priceless crumbs from your cranial cracker barrel.

May I suggest in the future when addressing the “numerous Ohioans spoiled rotten whiney children” you write in manner they might understand, thus not losing your point!

What does Batman have to do with this topic? Anyone spending more than $2510 on medicine, $200+ a month, is probably ill, elderly or disabled or worse. Highly unlikely are they standing in lines at movies or attending “river” festivals. Read the topic ED!

By the way, where in the scheme of things does a half a billon spent on the Caped Crusader compare with the modern day Crusader’s $200,000,000 per day spent in Iraq? Could we buy a little health care with that ED? Maybe…

I have to wonder ED, what kind of life you must live. Evidently not affected by $4 a gallon gas, $15 beef roast, $4 for a gallons of milk, rising property taxes, making fun of people who run or need soup kitchens. How lucky you must be.

Be careful when you drive in your rose-colored glasses that you don’t hit any of the “numerous Ohioans spoiled rotten whiney children” standing in line for the next Batman movie… OK Ed?

Anonymous

I remember in the eighties when these people were working or retired from the railroad. I had to be quick & get my "free" cheese for my young children & wife. These people were on "fixed" incomes. My wife & I wonder if we will have employment & we are getting close to the double nickel. You people really had it made compared to those in the workplace. I feel sorry for those trying to make it in today's job market.

Anonymous

Ricky:

Wasting time with pretentious blogging at 10:41 AM?

Caught a whopper eh? Better check the ‘ol creel and see who first responded to who’s comments.

When one throws around a few liberal baiting words, one never knows what socialist one might hook. I’ve got just the right place for you over my mantle – with your maw gaping and eyes bulging.

A self-described remedial reader like you obviously has difficulty with succinct conceptual thought. Thanks for hanging in there.

You pay $15.00 for a beef roast? I never touch it. Red meat will kill ya. Chicken or fish is better for ya and less expensive.

The point Ricky-boy is that despite the daily sobbing of the news media, U.S. is still the richest country in the world. Listen to the incessant whining long enough and one would think that we all live in Haiti where they do have soup and bread lines.

It’s time to raise whiny Ricky’s taxes. The bleeding heart liberal big government lovin’ rich boy writes like he ain't payin' his fair share in order to help fund State entitled healthcare for the rapidly increasing population of elderly and infirmed.

What do you think Ricky? Should there be windfall profit taxes on movies like ‘The Dark Knight’ to help pay for universal prescription drug coverage?

Anonymous

Ms. Daugherty:

Kindly write a piece about the results of the insurance forum.

I recently read an article where it stated that the Securities and Exchange Commission (SEC) wanted to take on the regulation of equity-indexed annuities.

The SEC wants them treated as investment products and not insurance contracts. Insurance agents who now sell them would have to become securities licensed.

I’ve seen the commercials for annuities on TV. They like to throw around the term ‘guaranteed income.’ If the insurance co. issuing the annuity should go out of business, they could become worthless. Some ‘guarantee.’

I’m old enough to remember the failure of annuity issuer Baldwin-United in the early 80s and the fiasco and financial loss it caused.

Annuities can have their place in a balanced financial retirement plan, but IMO, they are often oversold and to the wrong people for the wrong reasons.

Anonymous

TO: Expletive deleted

Well… tickle my toes pink, my new friend Ed wrote me a note! I’m impressed, and you cleaned up your grammar a little bit too. In light of my new found respect for you I’m going to address you as MR. ED.

I loved the fishing analogies MR. ED but from where I’m standing if I look in my CREEL I think I see a bug-eyed whopper with a George Will bowtie and a Ronald Reagan Christmas card in his back gill, all gaped mouth, looking back at me…

I can’t believe you are going to hector me for “wasting time at 10:41am”, how old are you MR. ED? Not all of us are in bed at 9:00pm like the president. You must know that in this blistering American economy we “workin poor” are at the millstone all different hours of the day. Come on MR. ED!

And yes, I do enjoy red meat; I especially enjoy chewing on glib wags such as you, thanks MR ED.

I don’t disagree with you on the amount of wealth in the country; my problem is the redistribution of this wealth. More and more money is going in to the pockets of fewer and fewer people. I don’t care if you have money. But I do care when my co-worker’s job is eliminated in order to raise the stock price so some piker like you doesn’t complain that is portfolio is tanking.

Windfall profit tax? That’s code for the oil companies aren’t stealing the American consumer blind? You own EXXON stock too MR ED?

We all can’t be millionaires, deep down inside even Rush knows this. Who would cook in restaurants, sell high priced gas, mow your yard, millionaires? I don’t thinks so. So is it really too much to ask that the guy cooking your brunch can take his kid to the doctor when he needs to and not when he can afford to? It seems like every other industrialized country in the world has already answered this question.

Please write back MR ED, I’ll give you one more response before I move on to the next pretentious, presumptive, pollyannaish, vamped up mutterer of the Rush Limbaugh-Bill O’Rielly lemmings. (Was that sentence too pretentious Mr. Ed?) I so enjoy the rain of bull crap from the mouths of Republicans. (or chicken crap in your case)

One last thing, when you write me (or your next president) please put a capital B on Boy…

Ricky Boy Studer

Rick Studer

MR.Edddd...

Anonymous

Ricky:

Huh. Give you a few pixels and you produce bloviating novellas. Nice useless talent. In this forum short and sweet is preferred.

Since you know absolutely nothing about me personally, your only recourse is to dig into your liberal, socialist cesspool of a mind and pull up your typical nonsensical sludge and arrive at absurd conclusions.

If you could make the effort to attempt to exchange ideas and ask questions without the immature ad hominem attacks at which liberals like yourself excel, you might actually occasionally appear intelligent and perhaps learn something useful in the process.

You appear to sincerely believe that your Mr. ED analogy was clever; but you gotta ask yourself, in that relationship – who truly owned whom?

Got anything worthwhile to discuss, or would you like to continue with your usual drivel?

Rick Studer

ED… It’s truly frustrating trying to communicate with you, I’ll give you that. My last post contained at least 3 topics for discussion; did you ignore them or just not get it? I can’t tell.

I write too many words? I’m sorry about your attention span, perhaps if you got a longer view of things you might develop some ideas, really, have you actually put forth any in these post. I can’t find any. You’re just as critical as me in your writing style, only not as creative.

As for Mr ED, actually I’ve never seen it, a talking jackass didn’t appear interesting, too many real ones to watch. I didn’t think the analogy was clever, I thought it would irritate you, and it seems to have served its purpose since you mentioned it. Do you own me? You can’t really believe you could offend me now did you?

As for the arena of ideas I think you’ve failed Rush and Bill miserably, but its good to know you’re on their side.

Remember, Ignorance is Bliss, (for your tombstone)

Rick

P.S. Hope this was short and sweet, like you… Bye, Bye Ed