Is there any "gap" plan we can buy to help cover what Medicare Part D isn't?

4 answers | Last updated: Nov 19, 2016
Bobc31 asked...

My Dad is on Medicare and has Medicare Part D (prescription). He has entered a gap or "donut hole" which means he has to pay 100% until he reaches about $5000 out of pocket. Is there a way to buy a plan that will cover this gap? We tried to get assistance for low income, however, he was over by $25 in assets and did not qualify (Yes. I know. I could not beleive this and I fought for 6 months to show them that their money goes to insurance, food and prescriptions). Any help would be greatly appreciated. Bob


Expert Answers

There are at least two things you can do. The first is to try to find free or low-cost prescription drugs for the time your father is in the donut hole. There are a number of programs and tactics for seniors on Medicare to obtain free or low-cost medications; they are explained in the article Saving Money on Prescription Drugs When Your Parent's Not Covered by a Medicare Part D Plan.

If it's likely that your father will find himself in the same position next year, the other thing you can do is to shop for a new Medicare Part D prescription drug plan that provides some coverage during the gap. If you find a plan, in the state where he lives, that provides your father with better coverage, he may switch to it during the Part D open enrollment period between November 15 and December 31. There are not many plans that provide gap coverage, the gap coverage is not usually that extensive, and the premiums for these plans are usually higher than for other plans. Nonetheless, it's worth at least shopping for a plan with some gap coverage, as long as any new plan also has good pre-gap coverage for his regular medications.


Community Answers

Jo c answered...

After you've exhausted every suggestion by Mr Mathews you will reach the point, as I did caring for my mom; it became our responsibility to provide financial support to ensure she got the necessary care-including scripts.

I and my husband willingly made sacrifices thru-out mom's last 5 years & would do it all over again. Sadly family values have eroded, children are dumped in day care, elderly parents are dumped in nursing homes.

This is one possible solution to your frustrations not necessarily the answer you're searching for. I wish you well.......Jo C.


A fellow caregiver answered...

Its not that some dump their elders in nursing homes. Sometimes when there are certain things like a bi level home makes it hard to keep elders from using the steps that have two or three landings and they can hurt themselves and have future injuries . I think if you find a nursing home near your home you can at least spend time with the elders, or at least a few hrs. every day or night to make sure they are taken care of. You don't have to feel bad about doing this as its for their own benefit. CT


A fellow caregiver answered...

Bob, My husband will be in the Gap, or donut hole again. I have been looking on the internet for discounts on each prescription, Look under the drug brands. this may help.