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Medicare Part D Donut Hole: How to Close it Yourself

Millions of seniors fall into Medicare Part D's hated "donut hole," where you can potentially spend thousands of dollars out-of-pocket on prescription drugs. Our leaders proudly proclaimed that health care reform would eventually close Medicare Part D's donut hole by 2020, although, as I've written previously, even then, you might still spend a lot of money on prescription drugs.

Cash-strapped retirees need to make every dollar count, so they should be looking for alternatives to paying a lot of out-of-pocket money for expensive prescription drugs. It turns out that many people do have options. Let's take a look.

Here's a list of the ten prescription drugs that generated the highest dollar volume of sales in the United States in 2009, along with the condition for which they were prescribed:

Source: IMS Health, which provides pharmaceutical information to the healthcare market.

Now let's take a look at whether there are lifestyle alternatives that can help these conditions. Mayo Clinic has a comprehensive website that describes many diseases and chronic conditions, including their causes and treatments, and whether there are potential lifestyle remedies. The chart below again lists the conditions in the above table and notes which ones the Mayo Clinic website offers lifestyle remedy suggestions for.

1. Source:
The lifestyle solutions suggested on the Mayo Clinic site typically include maintaining a healthy weight, eating a healthy diet, getting sufficient exercise, stopping smoking or being around second-hand smoke, and managing your stress. Some conditions had additional lifestyle suggestions that were more specific to that condition. It's important to point out that the first four conditions are particularly responsive to lifestyle remedies.

Now I have to be careful here. I'm not suggesting that every one of the above conditions can be cured through a lifestyle remedy. I'm also not suggesting that people who take these prescription drugs are lazy or undisciplined. And I'm not criticizing the doctors who prescribe these drugs or the pharmaceutical companies that develop and manufacture them. I'm simply pointing out that if you're taking one or more prescription drugs, you might have some lifestyle options for reducing your out-of-pocket expenditures.

According to a study by the Henry Kaiser Foundation, the average annual number of retail prescriptions purchased in 2009 for Americans age 65 and older was 31.2. This number includes both new and refilled prescriptions, and both brand name and generic drugs. Surely a good number of these prescriptions could be reduced through lifestyle modifications. In fact, you can see this is a definite possibility by examining the survey results by state, which show a low of 16.2 average annual prescriptions in Alaska to a high of 47.1 in Tennessee. What are our Alaskan neighbors doing, or not doing, compared to our friends in Tennessee?

It might be worth asking your doctor about a medically supervised lifestyle program that can safely wean you off your expensive prescription drugs.
I know people who have done this. One friend of mine had high cholesterol levels due to a hereditary tendency, and he got his cholesterol levels down to safe levels through diet and exercise, in spite of his initially skeptical doctor. It took a lot of effort, but now he feels great and is proud of his accomplishment.

Lifestyle solutions won't work for everybody, but with some work, millions of people can still improve their health and reduce their dependence on expensive prescription drugs. And if you're trying to make every dollar count in retirement, this should be an important part of your retirement planning.

Image from iStockphoto contributor Kameleon007
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