Home   About Prilosec OTC   Sampling   Tools   FAQs   Patient Education Materials   In The News Login

When your senior patients talk to you about Medicare Part D, you probably hear a lot of concern about the Coverage Gap (the phase during which patients pay 100% of prescription costs). Let your patients know that the Medicare initial coverage limit for 2009 is $2,700 – once their expenses reach this limit, they will enter the Coverage Gap. Both the portion that Medicare covers and the portion they pay out of pocket for prescriptions count toward this limit.

Let seniors patients know OTC medications can help them save.
Remind senior patients that because OTC medications are paid for solely out of pocket, they don’t count toward the coverage limit. Prescription medications, on the other hand, do. Choosing OTC alternatives when possible will free up Part D coverage dollars for more costly prescription-only medications. By sharing this information with your patients, you can help them delay or avoid the Coverage Gap.

Our Medicare Part D kit is a great resource for your patients. Each kit includes an educational brochure that will help patients understand Medicare Part D coverage. It also includes a tracking tool to help your patients track the spending that counts toward their coverage limit. Download the kit or order kits for your office.

Here are three tips you can share with your senior patients to help
them save:

1. Consider over-the-counter (OTC) medication alternatives
   • OTCs DO NOT count toward the Coverage Gap.
2. Consider generics
   • Generic prescription medications can lower spending, but they still count toward the Coverage Gap.
3. Apply for help if they have limited income
   • Call 1-800-772-1213 for extra help with Part D.
   • Call 1-888-4PPA-NOW or go to www.pparx.org to learn more about patient assistance programs.

Offer your patients the following example:
See how Peggy's tab was affected by her prescription spending ...

• Peggy's two copays add up to $65 each month
• Part D pays for the rest--$205 each month
• Her total monthly tab: $270 ($65 + $205)
• At this rate, Peggy will reach her initial coverage limit in 10 months' time ($270 x 10 = $2700 Phase 1 coverage limit)

• For the last 2 months of the year, Peggy will have to pay the full cost of both medications: $540 total ($270 x 2)
• At the end of the year, she will have spent $1190 ($65 x 10 months + $270 x 2 months)

NOW see how Peggy changed her situation.

By planning ahead and talking with her doctor, Peggy found an appropriate OTC alternative for one of her medications ...

• Using a $20 OTC instead of prescription “Medication A” brings Peggy’s total monthly costs to $70, but the OTC doesn’t count toward her Part D tab
• Peggy spends $5 more each month, but only $200 ($50 + $150) counts toward her tab
• At this rate, Peggy won’t reach her initial coverage limit this year ($200 x 12 = $2400)

• At the end of the year, she has spent $840 vs $1190 that she would have spent without an OTC substitute ($65 x 10 months + $540 for the last 2 months)
• $1190 vs $840—that’s a savings of $350!

Download Medicare Part D kit

Order Medicare Part D kits for your office

†Seniors must consult their physician to determine if an OTC is the appropriate therapy for them. Seniors can save if they are on multiple chronic medications.

Prilosec OTC En Español