Members enrolled in BlueMedicare Rx Option 2 enjoy
the extra benefit of knowing
they are covered for generic
drugs during what has become
known as the Medicare Part D
doughnut hole. The doughnut
hole is a gap in coverage for
prescription drugs once your
total prescription drug costs
(what you and your Medicare
Part D plan pay combined)
exceed $2,400 this year. Coverage
doesn’t resume until those
costs reach $5,451.25.
If you are not enrolled in
Option 2 and you think you
may fall into the coverage gap,
there are several strategies you
can use to either avoid or delay
reaching the doughnut hole.
Generic drugs
Whenever possible, ask your
doctor to prescribe generic
drugs. These can help minimize
your overall prescription
drug costs.
Your copayment for a generic
drug is only $5 until your drug
costs reach $2,400, and it may
be even less for some particular
drugs. That’s a savings of
at least 80 percent over the
cost of many preferred
brands and even more
over many non-preferred
brands.
The Food and
Drug Administration
(FDA)
requires generic
drugs to be as
safe and effective
as their
brand-name
equivalents.
They also must
have the same
quality, strength,
purity and stability
as brand-name
drugs. Generics
represent 56 percent of the
total prescriptions dispensed in
the United States, according to
the Generic Pharmaceutical
Association.
In 2006, the FDA approved 67
prescription drugs in generic
form for first-time use, resulting
in more choices than ever
when it comes to generics.
According to the FDA, 8,730 of
11,487 prescription drugs have
generic alternatives available.
To see if a generic is right for
you, talk with your doctor or
pharmacist.
Substitute preferred
for non-preferred brands
The BlueMedicare Rx formulary
includes four tiers: generic,
preferred brand, non-preferred
brand and specialty drugs. A
generic may not be available
for newer drugs for which
the patent has not expired.
However, you can still save
money. If you are taking a non-preferred
drug, ask your doctor
if there is a less-expensive
alternative from the preferred
brand list that will work just as
well. Many times newer drugs
are more expensive but do not
work more effectively than
those already on the market.
