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Joan, a Medicare beneficiary, has Crohn’s disease with an ileostomy, cardiac disease with four
stents, chronic interstitial cystitis, diabetes, generalized osteoarthritis with cervical and lumbar
spondylosis, and is status post unilateral knee replacement. In August, Joan entered the doughnut
hole. Why? How can Joan get out of the doughnut hole?
Solution
Joan got in to donut hole because he spent more than certain dollor amount which is pre-decided
for each year.
Joan should start using lower-cost drugs which will make his initial coverage last longer. He
needs to consult to his doctor if less-expensive brands or generics ordrugs would work just as
well as the ones Joan now takes.

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  • 1. Joan, a Medicare beneficiary, has Crohn’s disease with an ileostomy, cardiac disease with four stents, chronic interstitial cystitis, diabetes, generalized osteoarthritis with cervical and lumbar spondylosis, and is status post unilateral knee replacement. In August, Joan entered the doughnut hole. Why? How can Joan get out of the doughnut hole? Solution Joan got in to donut hole because he spent more than certain dollor amount which is pre-decided for each year. Joan should start using lower-cost drugs which will make his initial coverage last longer. He needs to consult to his doctor if less-expensive brands or generics ordrugs would work just as well as the ones Joan now takes.