July 14, 2006
Contact: Jerry Carey
Phone: (856) 566-6171
Geriatrician Provides Tips on Surviving the “Doughnut Hole” of Part D
STRATFORD — Millions of older Americans who purchased Medicare Part D coverage are experiencing one of the complicated - and costly - aspects of their plan, often referred to as the “doughnut hole” in the new prescription coverage for seniors.
“Under the basic model, seniors pay an annual deductible and then a co-payment until the total cost of their prescriptions reach $2,250,” said Dr. Thomas Cavalieri, director of the New Jersey Institute for Successful Aging and the dean of the UMDNJ-School of Osteopathic Medicine. “After that, they pay the entire cost until their out-of-pocket cost for the year reaches $3,600. Many seniors will find themselves entering this gap in coverage over the next couple of months.”
Once the total out-of-pocket amount $3,600, Part D coverage will pay 95 percent of the remaining cost of prescriptions for the year. Estimates vary, but one recent report said that as many as 195,000 New Jersey residents, and more than three million people nationwide, could find themselves in the “doughnut hole” in 2006.
Dr. Cavalieri offered these tips to seniors to help ease the financial impact of the coverage gap:
Switch to generics. Many brand-name medications, including popular drugs like statins to treat high cholesterol, are available as less-expensive generic medications. Some Part D plans also continue coverage for generics through the doughnut hole.
Split your pills. If your prescription comes in tablet form, talk to your physician about getting the medication at double the strength you normally take. By taking half instead of a whole tablet, 30 tablets can provide a 60-day supply.
Ask about samples and discounts. Physicians sometimes have samples they can provide for free and a few companies still provide discounts to individuals who take certain medications.
Consider a new plan. With few exceptions, seniors can’t switch plans this year, but beginning in November, they will be able to sign up for a different plan for 2007. With this year’s experience in mind, some individuals may find it cost-effective to switch to a more expensive plan next year that offers coverage through the doughnut hole.
To request an interview with Dr.Cavalieri, please contact Jerry Carey, University News Service, at (856) 566-6171 or (973) 972-3000.
UMDNJ is the nation's largest free-standing public health sciences university with more than 5,500 students attending the state's three medical schools, its only dental school, a graduate school of biomedical sciences, a school of health related professions, a school of nursing and its only school of public health, on five campuses. Last year, there were more than two million patient visits to UMDNJ facilities and faculty at campuses in Newark, New Brunswick/Piscataway, Scotch Plains, Camden and Stratford. UMDNJ operates University Hospital, a Level I Trauma Center in Newark, and University Behavioral HealthCare, a mental health and addiction services network.