How can I prolong reaching the coverage gap?

Minding the Gap 

Below are a few suggestions to lower your total cost of your medications to increase the value of the initial coverage limit before you coverage gap.

• Checking into alternatives and/or switching to generics or lower cost drugs: Talk to your doctor about using generic and/or over-the-counter (OTC) drugs. Ask your doctor if your medication has a generic available. If not, ask if there is a similar medication that would be suitable that you can take that does have a generic available.  Many generics work the same or as well as the higher cost brand prescriptions. It can help you save hundreds of dollars a year and can be just enough to keep you out of the coverage gap.

• Use the mail-order programs:  Most PDP(s) have mail order programs that allow you to get a 90 day supply of your maintenance medications at a discounted price. Getting your prescriptions filled through your PDP’s mail-order pharmacy can save you hundreds of dollars a year in out of pocket cost with discounted copays (example: most programs will only charge you a 60 day copay for a 90 day supply from their mail order pharmacy vs. paying for the full 90 day supply at your local retail pharmacy) and increase the value of the initial coverage limit by lowering the total cost of your prescriptions by getting a bulk supply.

• Utilize a local retail pharmacy who offers a Generic Drug Program.  Some pharmacies that offer such a program are: Wal-Mart, Target, Rite Aid, CVS, and Stop & Shop.  These programs allow you to purchase 30 day supplies of commonly prescribed generic medications for as low as $4 for a one month supply and as low as $10 for a 90 day supply.  Some pharmacy's programs do not require you to use your Drug ID card so as a result; this will delay your reaching your coverage gap. (Check with each pharmacy to see their rates and conditions. Drug lists are subject to change, please check with pharmacy before purchase. Membership may be required).

• If you do eventually fall into the coverage gap there may be assistance programs available to help you pay for the cost of your medications. Organizations such as the National Patient Advocate Foundation or the National Organization for Rare Disorders may have programs that can help with your drug costs. Also, some drug manufacturers may have assistance programs available for some of their higher cost medications. Comprehensive information on federal, state and private assistance programs in your area is available at www.benefitscheckup.org.