How can I get financial help for my parents who are at their donut hole with their prescriptions?

1 answer | Last updated: Nov 18, 2016
A fellow caregiver asked...

Where do I find help for my parent's, they are both at their "donut hole" with their prescriptions and unless they are generic, they have to pay full price. How do they expect two senoirs who each take between 10-14 pills each a day to pay for them when they live strictly off social security?


Expert Answers

One of several big concessions Congress made to the pharmaceutical industry when enacting the Medicare Part D prescription drug program's was the "donut hole" -- a period of no coverage when each of your parent's total drug expenses for the year reach $2,510 but out-of-pocket costs haven't yet reached $4,050. But there are a number of places your parents can turn to find discounted prescription drugs during the donut hole.

You already know about cheaper generics as an alternative to brand name drugs. But even if there's no generic for the drug your parent is taking, there might be a virtually identical drug, perhaps with a generic, that is much cheaper. Your parent can ask the doctor whether there's a nearly identical drug, then ask his pharmacist if it's less expensive or if there's a generic.

Also pharmaceutical companies give doctors free samples of the medications. Before your parent fills an expensive prescription, he should ask if his doctor has any samples to tide him over until his Part D coverage kicks in again.

Some states and local communities have programs to help older people pay for a prescription drug when the patient isn't covered by a Medicare Part D plan. Some of these programs offer discounts on all drugs, while others help only with certain common drugs. Often such programs limit their help to low-income, low-asset seniors. To qualify, your parents would need to provide evidence of their financial situation. Some nonprofit organizations that cater to seniors have programs to help members get discounted prescription drugs. These include both national and state organizations, some connected to a particular professional, union, or fraternal group.

Also, some pharmaceutical companies have programs to help low-income seniors. The programs usually offer only small discounts on certain medicines. To get the reduced price, your parent must register directly with the pharmaceutical company's program. Many large pharmacy chains also set up discount programs for people with Medicare.

To find out more about these and other drug discount programs, see the article on this site  Saving Money on Prescription Drugs When Your Parent's Not Covered by a Medicare Part D Plan .   Also, the Medicare website has a link called  Lower Your Costs During the Coverage Gap , which directs you to information about state and local government and pharmaceutical company discount programs. You can get the same information by calling Medicare toll-free at 800-634-2273. Free information on discount drugs is also available from the federal government's Area Agency. To contact it, go to the  Area Agency on Aging's Eldercare Locator web page  or call 800-677-1116.