View Full Version : How do I avoid the Gap?
GTTPF
10-08-2011, 04:53 PM
I was wondering if there is a way to avoid the coverage gap in prescription plans. I take 19 different prescription medications daily. Some a couple times per day. I get generics whenever possible. Several of my medications do not have generics and I have been through all of the other alternative medications. Any Advice? Thanks in advance!
starflyte1
10-09-2011, 08:08 AM
My husband ran into the same problem. The only thing we did not try was buying from Canada.
CTgolfer
10-09-2011, 08:19 AM
Sweetbay has a prescription plan for $7 a year. If you purchase all your generics from them, the cost/month is minimal and more important, the cost doesn't get applied to your primary prescription plan. This frees up some dollars on your plan. Others I know who have reached their gap number, use the local Canadian pharmacies.
batman911
10-09-2011, 01:59 PM
Do not know anything about your medical history, but if my doctor(s) prescribed 19 separate drugs to be taken daily, I believe I would get a second and third opinion.
starflyte1
10-09-2011, 02:47 PM
GTTPF, I am sorry that the previous poster posted what he did. My husband took many drugs each day and was under the care of a cardiac electrophysiology doctor, and two cardiologists (one at Mayo Clinic) and a gp. All agree on the meds he is taking and all agree each is necessary. Due to the wonderful meds that are available, knowing what they do, and being able to take them, gives a quality of life that would not be available if the doctors and meds were not available.
Once you have lived with a condition requiring many drugs, you realize how lucky you are to have them.
GTTPF
10-09-2011, 05:27 PM
GTTPF, I am sorry that the previous poster posted what he did. My husband took many drugs each day and was under the care of a cardiac electrophysiology doctor, and two cardiologists (one at Mayo Clinic) and a gp. All agree on the meds he is taking and all agree each is necessary. Due to the wonderful meds that are available, knowing what they do, and being able to take them, gives a quality of life that would not be available if the doctors and meds were not available.
Once you have lived with a condition requiring many drugs, you realize how lucky you are to have them.
Thank you! I am in the same boat as your husband. I also have some other issuses. I have been to Cleveland Clinic and University of Pennsylvania on many occasions. I do my reasearch. I go to the best Drs in the country for my problems no matter where they are. I don't like taking the meds but they are keeping me alive for now. I have been battling cardiac problems for over 25 yrs and have used up all options on medications. The main med I'm on now just came out 2 years ago. When I build up a tollerance for that, well that's it. Other than a heart transplant ( which is not always a good option) This is the choice I have. My Drs don't put me on anything unnecessarily. I will put off a transplant as long as possible. As for the other poster he just doesn't understand that some people have no choice except to take multiple medications. No problem. My best toyou and continued health for your husband also. :thumbup:
Doodlegirl
10-10-2011, 01:15 PM
Write to the pharmaceutical company's of the most expensive drugs that are not generic. Most of them are willing and able to assist with monthly coupons to you that will lower the cost of the non generic immensely. My 50 year old niece did that with much success and thanks for her COPD. Plus, Florida may, may be able to assist you with a program they have for people "our" age
who cannot afford their prescriptions. I always hit the Gap until I found a
physician who was able to find a generic for the drugs I must take monthly.
For over a year now I am well under what is necessary and will not hit the
Gap unless something new is prescribed that could be very expensive. In which case I will look to the Company for assistance or the Florida plan which
assists folks on fixed incomes. Good luck, I do understand the stress of hitting
the Gap.
aljetmet
10-10-2011, 04:11 PM
If you indeed have a financial hardship and have expensive drugs that you cannot get a generic, the drug companies can help you out.
My wife is on medicare due to her disability. Her drug costs $44K per year. The drug company picked up the tab this year and we are waiting a decision for next year.
It only takes one month for her to reach the donut hole. Based on what medicare told me Friday, with the 50% drug discount in the donut hole, actual out of pocket costs max out at about $1,700....Then 5% of the cost of the drug cost for each month thereafter. I was on the phone with medicare Friday for about 40 minutes... They are very helpful!
Call them too!
GTTPF
10-10-2011, 05:20 PM
Thank you for the suggestions about getting help from the drug companies. I'm sure that I wouldn't qualify. I can afford it, but I would like to find a way to get the start of the gap raised. Just 1 of my prescriptions puts me into the gap. I still have 18 more to pay for each year. Are there any plans that have a much higher starting gap level. Thanks!
ilovetv
10-10-2011, 05:32 PM
Thank you! I am in the same boat as your husband. I also have some other issuses. I have been to Cleveland Clinic and University of Pennsylvania on many occasions. I do my reasearch. I go to the best Drs in the country for my problems no matter where they are. I don't like taking the meds but they are keeping me alive for now. I have been battling cardiac problems for over 25 yrs and have used up all options on medications......My best to you and continued health for your husband also. :thumbup:
With all the healthcare financing problems currently in the news, and the reform politics in the spotlight, I think people often forget how important it is to have the personal choice to go anywhere in the nation, to any dr. we choose....whether on private insurance or government plans like Medicare/Medicaid.
All the best to you in search of treatment and medicines.
GTTPF
10-11-2011, 12:35 PM
Thank you all for your help and input. I will look into Sweetbays program.:thumbup:
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