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• The Coverage Gap
• Out-of-Pocket Costs
• Coping with the Coverage Gap
• Choose Among Plans
• Learn About Drugs Covered
• Grievances, Exceptions & Appeals
• Switching Plans
• Find Extra Help Paying
• Get Personal Help

How can I lower my costs in the coverage gap?

You can do several things to lower your drug costs while you are in the coverage gap - especially if you have a limited income.

• If you have a limited income and assets, apply for the extra help available through Medicare Part D. If you qualify, you will have no coverage gap. Visit our extra help section to learn more about the extra help and see if you might qualify.
• If your state has a State Pharmaceutical Assistance Program (SPAP), consider signing up for it. Visit our SPAP section for more information.
• Apply for help from a certified charity like a co-pay foundation, if there is one for any of your medicines. See a list of these charities.
• If you're taking brand name drugs, talk with your doctor about switching to generic drugs. Generic drugs usually cost less, and some plans may cover your generic drugs if you reach the coverage gap. Or ask your doctor about switching to a lower-cost brand name drug that treats your condition.
• Apply for help from a Patient Assistance Program that serves people in Medicare Part D plans. Visit our PAP section for more information. If you use a Patient Assistant Program, you must submit your out of pocket costs to Medicare yourself, or they will not count towards your total drug costs. Check with your Part D plan to see how you should submit your out-of-pocket costs.
• See if your doctor can give you free samples of any of the medicines you take.
• Contact your county public health department to see if they have a free medicine program.

NOTE: In 2010, people with Medicare who do not get Extra Help will receive a one-time rebate check of $250 when they reach the coverage gap. The rebate check is tax-free and designed to help you pay for some of the out-of-pocket costs while in the gap. You will automatically get this check in the mail from Medicare within 45 days of hitting the gap. Be sure Social Security has your correct address. You can call 1-800-MEDICARE if you have any questions (TTY users, call 1-800-325-0778).

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