The Challenge of Medicare Part D by Mary Jane Stern

Medicare D and the "do nut" hole can be a real challenge if you require monthly medications and you take more than two brand name drugs.

Prescription drugs can be very costly and for those people who have long-term illnesses drug costs can put you out on the street quickly.  As a rule of thumb, Medicare D is for prescription drugs purchased at a pharmacy.  There are special rules for other drugs that are received in a doctor's office and are generally covered under Medicare Part B.

To begin, start RIGHT NOW and make a list of all the drugs you take.

Change Brand Name Drugs to Generic Drugs
Now that you have your list, schedule an appointment with your internist or primary care physician and see if there are any drugs that you can switch to a generic brand.  If so, get new prescriptions and go to another pharmacy and purchase these drugs without using your Medicare D plan.

Split Your Pills
Next look at your medications and see if any of your have a score line in them.  If they do, they can generally be split in half and you would want your physician to write a prescription for double the strength.  For instance, if you take 20 mg of Lipitor, have your doctor write the prescription for 40 mg and split the pill.  What you get is a 2 month supply for the cost of one month.  That can save you about $600 worth of retail charges against your Medicare D plan.

Purchase Prescriptions From Canada
Another option is to purchase your drugs from a reputable pharmacy in Canada.  We have found Canada to be a good source for medications.  We use www.canpharm.com.  Canada has guidelines for purchasing from these pharmacies.

We purchase a couple of drugs from Canada and found that one drug Diovan, a necessary drug for my husband, is very affordable.  Our co-pay in our plan $56 as it is not a preferred drug in the formulary.  We purchase the generic brand Valsartan from Canada and it costs us $23 per month.  (FYI - It can't be sold as a generic in the USA.)

No "Do Nut" Hole For Us
We have been able to take our $8,000+ retail costs against the allowable limit in Medicare D and reduce it to about $2,000 per year.  Our monthly co-pays and other prescription costs have decreased substantially by using generics and purchasing in Canada.  It's $83 per month for prescriptions and co-pays, plus $23 for the Medicare D premium or $106 per month.  And we haven't in over 2 years hit our allowable limit.