New AARP Calculator May Help You Avoid the Doughnut Hole

This year more than 3.5 million Medicare beneficiaries are expected to fall into the dreaded Part D doughnut hole—the gap in coverage when they pay the full cost of their prescription drugs while still paying premiums.

Now AARP has developed an easy-to-use online tool that shows Part D enrollees if and when they’ll hit the doughnut hole and suggests ways they can cut drug expenses to postpone the gap or even avoid it altogether.

The AARP Doughnut Hole Calculator works like this:

• It allows you to enter your ZIP code, the name of the Medicare drug plan you’re enrolled in, and the names and dosage of the medications you currently take.

• It then displays a chart showing your likely drug costs under your plan month by month through the year—and, if you’ll hit the coverage gap, when it starts and how much it will cost you.

• It also shows alternative drugs, such as generic or older versions of the ones you’re currently prescribed, that are considered equally effective but cost far less. (If no alternatives exist, the calculator says so.)

• It recalculates the chart to show how the savings generated from switching to the suggested drugs would prevent or delay your falling into the gap.

• It generates a letter that you can print and send to your doctor, asking him or her to consider whether the suggested alternatives would work well for you.

The calculator offers a tool personalized to your own circumstances—the specific drugs you take and the Part D plan you’re enrolled in. But the process is anonymous and confidential and no information is kept, its developers say.

Under an arrangement between AARP and Medicare, the data used in the calculator is the same that Medicare uses in its online prescription drug plan finder. Both sites are powered by the same company, DestinationRx. But AARP’s calculator is targeted specifically on the doughnut hole and takes only a short time to navigate.

The launch of the calculator comes just after President Obama announced that beneficiaries’ brand-name drug costs in the Part D doughnut hole would be cut by half, perhaps as early as July 2010, under a deal arranged by the White House and congressional leaders with the pharmaceutical industry.

The deal is a significant step toward AARP’s goal of having the coverage gap closed entirely, says AARP Executive Vice President Nancy LeaMond. “In the meantime, we also want to give Americans the tools they need to cut their drug costs and stay out of the gap in the first place,” she adds. “We encourage every person in Medicare Part D to take a few minutes to find the right drugs at the lowest prices.”

Patricia Barry is a senior editor at the AARP Bulletin.