Doughnut Hole

[MrCorey]

Hi;
I"m not sure which forum to post this in so I decided to chose general. Anyway, I am currently on Medicare & have Tufts as my other insurance. Today I went to pick up my prescription and it was over $400 dollars! I asked the girl what the heck was up with that and I had to refuse the medication as I cannot afford that, I am on SSD. She told me that I fell into the "doughnut hole".

Has anyone heard of this? Has anyone run into this? What exactly is it and what can I do about it? I cannot go without my medication, but I cannot afford to pay for it either.

Any help/advice would greatly be appreciated.

Sincerely;
Corey

Be Blessed
in Him;
-c-
" Now may the God of hope fill you with all joy and peace..." Romans 15:13 NASB

[Cats Meow]

I've never heard of that term, I know Ins. Co's have a schedule list, stating what they will pay, your probably on something new and unfortunately are SOL. I would first call your doctor explain you simply can't afford it, maybe he can write a script for something equivalent that's affordable. That's really messed up, sorry. Doctors get kick backs from pharm company reps for pushing the latest greatest newest thing.
May I ask what the medicine is?


Curiosity skilled the cat

[MrCorey]

Ok, I found out what a "doughnut hole" is and it worth sharing incase any of you find youselves in the same situation.

A "doughnut hole" means that I have spent all the money Medicare and Tufts allowed me for the year. Now, I have to pay $3,600 out of pocket for all my medications. Once I spend $3,600, Medicare and Tufts will begin to pay for my medications again. When I asked the man about this, this is the amount for everybody. However, some folks have Prescription Advantage and this is supposed to pay for whatever falls into the "doughnut hole". My mother has fallen into the "doughnut hole" however, she also is eligable for Prescription Advantage. Whereas, I collect too much from SSD to qualify for Prescription Advantage so I am stuck. I will either have to pay full cost for my medication or go without. I have decided it depends on how much the medication is whether I choose to pay for it or not. The medication that I found out about this was over $400 dollars. However, I called my doctor and told him about this. Seems I'm his first patient to fall into this, what he did was give me coupons for the next two months for this prescription for free. But I will still have to pay for all other medications.

It's a dirty trick that Pres Bush signed into law at the 1st of the year that nobody really knew about nor understood. When I went with Tufts, I even had the lady come to my house to explain the insurance and she never told me about this. Either she didn't know, or she didn't want me to know so I would sign up for Tufts. In either case, it's a dirty trick the government is playing on those of us with SSD and SS incomes.

Sincerely;
Corey

Be Blessed
in Him;
-c-
" Now may the God of hope fill you with all joy and peace..." Romans 15:13 NASB

[Cats Meow]

Thanks for sharing, that sure sucks! I guess it's time to look for better insurance or move to Canada.


Curiosity skilled the cat

[pain&drugs]

didn't know about the doughnut hole thing but thanks for the information as it will help me later when I reach the limits you posted

Justis

[Mike VG]

Sorry to hear that, Mr. Corey. No doubt one of the tactics our beloved leader has done to tear this country apart from the inside out with his Executive Orders. Mr. Cory I would advise you to find out the manufacturer's of each and every one of your drugs, call them on the phone, explain your situation to them and I'm sure you'll then be directed to the proper person. Again, explain your situation to them. Almost all of the Drug Manufacturer's have allotted a certain amount of money or drugs to people who cannot afford it. Time consuming, yes, but possibly well worth your while. There is another organization whose spokesperson is Montel Williams, the TV talk show host, representing a program called PPARx. They've kind of changed their name to Free Medicine Revolution. It is a legitimate organization that helps provide free medicine for people who have found themselves in situations such as yours. Their Link is: http://www.freemedicinerevolution.com/
The Lord will provide, Mr. Cory. God Bless you, sir. Mike VG
For we dare not make ourselves of the number, or compare ourselves with some that commend themselves: but they measuring themselves by themselves, and comparing themselves among themselves, are not wise. II Cor 10:12

[FMR]

Hi, I am one of the founders of Free Medicine Revolution at www.freemedicinerevolution.com. I just wanted to clarify that though we are definitely a legitimate organization, we are not affiliated with Montel Williams and the Partnership for Prescription Assistance as quoted in the bottom of this post.

The Partnership for Prescription Assistance is sponsored by the Pharmaceutical Research and Manufacturers of America (PhRMA,) a lobbying organization for the pharmaceutical industry. We salute the work of this organization and of Montel Williams for all they have done to promote Patient Assistance Programs in America.

You can find out more about the Partnership for Prescription Assistance at www.pparx.org or about our free pre-qualification tools on our website.

Wishing you Health and Hope,

Lleyton

Quoted Text:
Almost all of the Drug Manufacturer's have allotted a certain amount of money or drugs to people who cannot afford it. Time consuming, yes, but possibly well worth your while. There is another organization whose spokesperson is Montel Williams, the TV talk show host, representing a program called PPARx. They've kind of changed their name to Free Medicine Revolution. It is a legitimate organization that helps provide free medicine for people who have found themselves in situations such as yours. Their Link is: http://www.freemedicinerevolution.com/