How to Afford Your Meds in the Donut Hole—7 Strategic Ways

How to Afford Your Meds in the Donut Hole—7 Strategic Ways

Although the donut hole is closing and will be completely gone in 2020, many—like you—are still caught within its clutches. And the fact that it is disappearing doesn’t help you right now. But there are a few things you can do to get yourself out of this expensive mess. Just like you planned for retirement, you can use that same strategic, out-of-box thinking to get yourself within your budget for drug costs. Here are 7 ways.


Switch to Generics

Bargain shoppers will like this one. How many times have you bought the generic brand of a common product and found out that it tasted nearly identical? The same goes for prescription drugs. More often than not, there is a generic equivalent that has the exact same active ingredient as the brand name drug. In this case, making the switch will not affect the medication efficacy, but could lower your copays significantly.


Of course, you need to consult your doctor before this. Not all grocery generics are as good as name brand (ever try generic Oreos?), and it is the same for medications. Not all medications have a generic equivalent and some—you might find—don’t work as well for you, but this is very rare. In fact, according to the FDA, research shows that generics work just as well as name brand drugs.


Talk to Your Doctor

This one is simple, but that doesn’t mean it isn’t smart. Sometimes the smartest thing you can do is ask someone who is smarter than you! Doctors know the prescription drug industry, and they know your unique situation. Maybe you can switch to an over-the-counter equivalent? Or maybe they “know a guy”? (Wow…that sounded a lot shadier than I expected)  Anyhow…if anyone can help you lay out a plan, they can.


Ask for Free Samples

While you’re consulting with your doctor, ask for a freebie. A lot of times they have free samples around the office that they can give you. He probably won’t impart to you a 90-day supply of little packets, but every bit helps.


Split the Pill; Split the Bill

Most double strength pills are not double the cost. A lot of times they are even very similar in cost. So if you order your regular supply of pills at double the strength and split them, it could save you big time. For a lot of prescriptions, it lasts double the time, leading to a 2 for 1 deal.


However, you need permission from your doctor to do this. Doing it unsafely or to a pill that wasn’t created for it can be potentially dangerous.


For more information on how to split pills safely, visit WebMD’s article “Guide to Pill Splitting”


Compare Pharmacies

Prices for prescription drugs can vary depending on which pharmacy you buy them from. Some have more expensive copays, and some are just more expensive in general. Your default pharmacy may not always be the best one, so price checking is always a good idea.


A few of our clients tipped us off to this wonderful online resource for shopping pharmacies called You just plug in the medication you want to shop, and the tool automatically compares the prices for that drug to find the pharmacies that offer the drug at the lowest cost. You can even print out coupons or access them via their mobile app, leading to even more savings.


Consider Mail Order

Not only is it more convenient, but it is also more cost-effective. Quite a few prescription drug plans offer a discount for switching to mail order. In fact, according to American College of Physicians President, Wayne J. Riley, you can save one-third on name-brand drugs by using mail order (from Money Magazine’s website).


Ask For Help

If all else fails, ask for help. Sometimes it is the most strategic thing you can do. There are assistance programs through charitable foundations and through pharmaceutical companies. Of course, they hope you find another way to pay for your medications, but at the end of the day, they won’t let you go untreated.


Here is a link to’s  pharmaceutical assistance program index. Just search for the Medication you can’t afford, and it will tell you the eligibility requirements for that drug manufacturer’s assistance program.


It’s no secret that many people are counting down the days until the coverage gap is finally gone forever. I know I can’t wait for it to be gone. It is such a hassle for both my clients and I. But until then, I recommend putting some or all of these items to the test. You’ll be glad you did.


Looking to switch your Drug Plan? Seniormark can help. Call us at 937-492-8800 to sign up for a free consultation.

About the Author