7 tips to help with the Medicare donut hole

These seven tips can help you save time, money and frustration when trying to understand Medicare prescription drug costs.

Getting the best prices on medicines is always good – and it may be extra helpful for people on Medicare who are trying to avoid that pesky donut hole.

Try these tips to lower your prescription costs:

1) Compare plans each year during the open enrollment season. The Medicare.gov website is the best place to do it. Make sure your plan still covers your prescriptions, check whether the price of your drugs is going up and see whether a different plan could save you money.

2) Talk to your doctor about ways to save money on your prescriptions. You might be able to switch a brand name to a generic, lower the amount you take or even stop taking a medicine you no longer need.

3) Talk to your pharmacist. He or she can sit down with you, look at all the prescriptions you take and give you ideas of other less expensive prescriptions you might be able to take. You can get ideas about combinations of prescriptions that might make you feel better and discuss these with your doctor. This is called a Medication Therapy Management consultation, and all Medicare prescription drug plans (Part D) cover it.

4) Ask your insurance company if you can get better prices on prescriptions at a different pharmacy, by mail or by getting a different quantity (like a 90-day supply instead of a 30-day supply).

5) Use cost calculators to find the best prices on prescriptions. If you have an online account for your health plan, look around for a calculator tool where you can put in the prescriptions you take and how much you need. It’ll tell you how much it’s going to cost you at different pharmacies. It might not be cheapest at the corner drugstore.

6) Ask local pharmacies if they offer discounts on your prescriptions or have a rewards program that can help you save money.

7) Get help paying for prescriptions by visiting medicare.gov to learn more about the programs that are available to help you.

Some people can’t avoid the donut hole completely. If there’s a good chance you’re going to hit it, smart planning can help you prepare for it.


#1: If your pharmacy is ringing you up and your prescription costs more than you think it should, stop and don’t pay for it. You can’t return prescriptions, even if there’s a mistake. Call your health insurance company and ask about the cost to make sure it’s correct before you finish checking out. You may have unexpectedly hit the donut hole.

#2: Think about timing. If you’re in the donut hole and nearing the end of the year, assess what prescriptions you really need to buy now. Do you have enough medicine at home to get you through the end of the year? Could you get a smaller quantity this time since you’re paying a higher price?

You are reading the “Medicare Donut Hole” series.

Confused about the Medicare Donut Hole? This series can help you learn how to prepare for it.

Part 1: How can I prepare for the Medicare donut hole?
Part 2: What is the Medicare donut hole?
Part 3: How to avoid the donut hole in Medicare

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