The Medicare Donut Hole Explained

The Medicare Donut Hole Explained

Medication Assistance

What is the Donut Hole?

The coverage gap, commonly called the “Donut Hole” is a temporary limit on what your Medicare Prescription drug plan will pay for your prescription drug costs.

While you are in the “Donut Hole”, you will pay higher costs of for your brand-name drugs. Often times these increased costs make your medications unaffordable.

If this sounds like you or someone you know, call Simplefill Prescription Assistance programs to enroll in their program during this period. 1-877-386-0206

The experts at Simplefill make understanding your Medicare Part D plan…well Simple!

There are 4 stages to your part D plan. Let’s break it down for you.

Stage 1: Deductible Phase
In this stage, you must pay a certain amount out of pocket before your prescription drug plan will kick in. This amount varies by plan.

Stage 2: Initial Coverage Phase
After you hit your deductible, you will start paying the plan’s cost share for covered medications. Once you and your prescription plan have spent $3,310.00 in 2016 for covered drugs; you’ve reached the “Donut Hole”.

Stage 3: The Donut Hole, Coverage Gap Phase
This is the stage where you start getting that sticker shock. Unless you want to wait until January 1st when your plan resets, you will now be paying 50% of the retail price of your medications. This can be very expensive and not an option for most patients, especially ones who are on fixed incomes.
This is why we urge you to contact us at 1-877-386-0206 or apply for assistance online.

Stage 4: Catastrophic Phase
You get a bit of a break in this stage since you have spent so much out of pocket for the year. During the catastrophic stage, you pay whichever amount is greater –either 5% of the covered drug cost or $2.65 for generics and $6.60 for brand name drugs.

What if I am not in the coverage gap but I still cannot afford my medications or my medication is not covered at all?
It never hurts to pick up the phone and ask. Often times we can help patients when their medication is not covered or if they have a copay is unaffordable. We always advise our patients to call us and we can find them the best way to save money on their medications. Think of the team at Simplefill as your Medication Savings Advisors!

Four Tips to Keep Your Heart Healthy

Four Tips to Keep Your Heart Healthy

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Simplefill cares about your good health. In honor of American Heart Month, we are offering four heart health tips that are easy to integrate into your lifestyle. The best part? They’ll keep you healthy and strong.

Get Your Body Moving

Aerobic exercise, which raises your heart rate, is one of the best ways to prevent heart disease. American Heart Association recommends at least at least 30 minutes of physical activity five times a week to keep your heart healthy. Regular aerobic exercise, including walking, jogging, cycling, and swimming, reduces the risk of heart disease by up to 60 percent.

Embrace Heart-Healthy Eating Habits

The foods with which you fuel your body impact the health of your heart. Stay away from sugary drinks, refined grains, and processed meats, which are typically loaded with trans-fats, cholesterol, and saturated fats. Instead, reach for these heart-healthy foods: whole grains, salmon & tuna, almonds & walnuts, spinach & carrots, and even dark chocolate. Mayo Clinic explains that a good rule of thumb is to eat as many fresh fruits, veggies, and whole grains as possible… And to avoid processed foods at all costs.

Give your Body the Shut-Eye it Needs

According to the Society for Cardiovascular Angiography and Interventions, insufficient sleep increases the risk of heart disease. Adults need seven to eight hours of shut-eye each night to get adequate rest, and children require nine or more hours. Getting enough sleep doesn’t just improve the health of your heart; it also improves moods, boosts energy levels, and strengthens the immune system

Maintain a Healthy Weight

According to the American Heart Association, obese and overweight people are significantly more likely to develop cardiovascular disease than those who are a healthy weight. Speak to your physician to determine whether your weight is putting your heart at risk.

In addition to these helpful tips, Simplefill offers affordable and accessible prescription medication to help with heart conditions. We are proud to prescription assistance programs for uninsured and underinsured Americans. Contact us for more information about how to get free or low cost prescription medication.