Frequently Asked Questions about The Donut Hole or Coverage Gap

Dec, 31 2022 — Your Medicare Part D prescription drug plan coverage starts again each year — and along with your new coverage, your Donut Hole or Coverage Gap begins again each plan year. For example, your . . .

Aug, 28 2022 — Aside from the 75% Donut Hole discount that you receive on all formulary drugs purchased in the Coverage Gap, your Medicare Part D prescription drug plan may also provide additional or supplemental Do . . .

Nov, 09 2022 — There are four possible parts to your Medicare drug plan coverage: (1) the Initial Deductible, (2) the Initial Coverage phase, (3) the Coverage Gap or Donut Hole, and (4) Catastrophic Coverage (all fo . . .

Nov, 25 2022 — If you use a Special Enrollment Period to change Medicare Part D drug plans during the year, your drug purchase history moves with you to your new Medicare plan. So if you are in the Donut Hole and move to another Part D plan, most likely you will still be in the Donut Hole.

Jul, 26 2022 — No.  If you qualify for the Medicare Part D Extra Help program or Low-Income Subsidy (LIS), then you will never enter the Donut Hole or Coverage Gap -- and the cost of your prescriptions will r . . .

Feb, 05 2022 — Review your Explanation of Benefits.  Each month, your Medicare prescription drug plan will send you a printed Explanation of Benefits letter that will show you how close you are to entering . . .

Feb, 06 2022 — Yes.  Our Medicare Part D Donut Hole Calculator or PDP-Planner is designed so seniors and other Medicare beneficiaries can see how their Part D drug spending could change throughout the year and . . .

Feb, 05 2022 — Yes.  If you use a great number of medications or one or more expensive medications, you can spend your way into, and out of the Coverage Gap or Donut Hole rather quickly. Review: When do you . . .

Aug, 21 2022 — Only the retail cost of formulary drugs purchased with your Medicare Part D prescription drug plan count toward entering the Coverage Gap or Donut Hole.  Only your out-of-pocket drug spending (Tr . . .

Apr, 27 2020 — If you reach the Coverage Gap, you will receive a 75% discount on all of your Medicare Part D plan's formulary drugs.  The Donut Hole Discount has increased over the past years, but should remai . . .

Oct, 16 2020 — You can determine when (or if) you will enter your Medicare Part D Donut Hole or Coverage Gap by just dividing your Medicare Part D prescription drug plan's Initial Coverage Limit by 12 months and t . . .

Nov, 13 2022 — Maybe.  Some Medicare Part D plans offer some additional coverage to plan members reaching the Donut Hole or Coverage Gap.  If you are using generic drugs, you will pay the plan's co-pay in . . .

Mar, 13 2022 — The Donut Hole (or Coverage Gap) is the third part of your Medicare Part D plan coverage and is a term used to describe a "gap" or pause in your Medicare Part D prescription drug coverage where - pri . . .

Aug, 28 2022 — If your formulary medications have a total retail cost over $370 each month, you will exceed your 2022 Medicare Part D plan's $4,430 Initial Coverage Limit and enter the Donut Hole or Coverage Gap sometime before December 31st.

Aug, 22 2022 — Yes.  If your Medicare Advantage plan includes prescription drug coverage (MAPD), then the Donut Hole or Coverage Gap portion of your coverage works just like a stand-alone Medicare Part D pres . . .

Dec, 31 2022 — Your Medicare Part D prescription drug plan coverage starts again each year — and along with your new coverage, your Donut Hole or Coverage Gap begins again each plan year. For example, your . . .

Nov, 25 2022 — If you use a Special Enrollment Period to change Medicare Part D drug plans during the year, your drug purchase history moves with you to your new Medicare plan. So if you are in the Donut Hole and move to another Part D plan, most likely you will still be in the Donut Hole.

Nov, 13 2022 — Maybe.  Some Medicare Part D plans offer some additional coverage to plan members reaching the Donut Hole or Coverage Gap.  If you are using generic drugs, you will pay the plan's co-pay in . . .

Nov, 09 2022 — There are four possible parts to your Medicare drug plan coverage: (1) the Initial Deductible, (2) the Initial Coverage phase, (3) the Coverage Gap or Donut Hole, and (4) Catastrophic Coverage (all fo . . .

Aug, 28 2022 — Aside from the 75% Donut Hole discount that you receive on all formulary drugs purchased in the Coverage Gap, your Medicare Part D prescription drug plan may also provide additional or supplemental Do . . .

Aug, 28 2022 — If your formulary medications have a total retail cost over $370 each month, you will exceed your 2022 Medicare Part D plan's $4,430 Initial Coverage Limit and enter the Donut Hole or Coverage Gap sometime before December 31st.

Aug, 22 2022 — Yes.  If your Medicare Advantage plan includes prescription drug coverage (MAPD), then the Donut Hole or Coverage Gap portion of your coverage works just like a stand-alone Medicare Part D pres . . .

Aug, 21 2022 — Only the retail cost of formulary drugs purchased with your Medicare Part D prescription drug plan count toward entering the Coverage Gap or Donut Hole.  Only your out-of-pocket drug spending (Tr . . .

Jul, 26 2022 — No.  If you qualify for the Medicare Part D Extra Help program or Low-Income Subsidy (LIS), then you will never enter the Donut Hole or Coverage Gap -- and the cost of your prescriptions will r . . .

Mar, 13 2022 — The Donut Hole (or Coverage Gap) is the third part of your Medicare Part D plan coverage and is a term used to describe a "gap" or pause in your Medicare Part D prescription drug coverage where - pri . . .

Feb, 06 2022 — Yes.  Our Medicare Part D Donut Hole Calculator or PDP-Planner is designed so seniors and other Medicare beneficiaries can see how their Part D drug spending could change throughout the year and . . .

Feb, 05 2022 — Review your Explanation of Benefits.  Each month, your Medicare prescription drug plan will send you a printed Explanation of Benefits letter that will show you how close you are to entering . . .

Feb, 05 2022 — Yes.  If you use a great number of medications or one or more expensive medications, you can spend your way into, and out of the Coverage Gap or Donut Hole rather quickly. Review: When do you . . .

Oct, 16 2020 — You can determine when (or if) you will enter your Medicare Part D Donut Hole or Coverage Gap by just dividing your Medicare Part D prescription drug plan's Initial Coverage Limit by 12 months and t . . .

Apr, 27 2020 — If you reach the Coverage Gap, you will receive a 75% discount on all of your Medicare Part D plan's formulary drugs.  The Donut Hole Discount has increased over the past years, but should remai . . .