I will look into the AAA discount. I wonder if it is available if you are already paying for drug insurance.
Remember that the accumulation of benefits that gets into into a doughnut hole situation is the total cost of your co-pay plus whatever the insurance co. pays. These figures will show up on your claims. Pharmacies have vastly different charges to the insurance co, so even though your co-pay might be the same at different pharmacies, the total cost of the claim is what you have to watch.
The only negative we have ever experienced, if you can even call it a negative, is that last year Mr. R got a letter from his insurance company stating they were concerned we wasn't taking his medications properly. Mr R is diabetic, takes high blood pressure stuff, etc. and he had no claims for these prescriptions. So apparently they assumed he wasn't taking the drugs.
He does take one expensive drug, but by putting all the others outside of insurance, he has never entered the dreaded doughnut hole.