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Meeting Prescription Assistance Requirements
Sep 4, 2009

I am facing a situation where I will be financially unable to meet the initial costs of my medication at the beginning of the year when my prescription assistance expires. Do programs ever make exceptions to their programs that require Medicare Part D clients to pay until they reach the donut hole in coverage? I realize this is a very specific question and might vary from program to program but I'm afraid I'm going to lose my medication at the first of the year. Any suggestions would be appreciated.

Response from Ms. Franzoi

I am not sure what your question is but let me provide you some information that might be helpful. I am assuming that you have Medicare, including Medicare Part D. You pay a monthly premium for Medicare Part D. This premium varies by the plan chosen. Until you reach the donut hole, you must pay a percentage of the cost for your prescription drugs. Once you reach the donut hole, you must pay 100% during that period and then Medicare Part D kicks in again once you are out of the donut hole. Currently, unless a pharmaceutical company is offering assitance, I don't know what is available to you during the donut hole period. Some Medicare Part D plans offer some coverage during the donut hole but it is usually for generic drugs. There is a federal Special Assistance program that helps offset the monthly cost of Medicare Part D premium. Also, there are some proposal pending that would offer some assistance in 2010 for individuals during the donut hole period.

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