Frequently Asked Questions about Donut Hole Discounts

May, 24 2024 — You will receive a 75% discount on all formulary drugs if you reach the Donut Hole or Coverage Gap. Changes coming to the Medicare Part D Donut Hole. Spoiler Alert:  In 2025, the Inflation Re . . .

Jul, 13 2024 — Both.  When you purchase your medications, the retail cost of your drug can move you from one part of your Medicare Part D plan coverage into another part. When this occurs and your prescripti . . .

Sep, 09 2024 — Yes, you are responsible for the copayment of the formulary drug purchase in the Initial Coverage phase - plus - the cost-sharing on the amount of the purchase price that exceeds your Medicare Part D . . .

May, 24 2024 — 95% of your brand-name drug's retail cost is counted toward exiting the Donut Hole. If your monthly purchases of formulary medications consistently have a retail value of over $420, you will ex . . .

Jul, 06 2024 — Maybe. Even with the 75% Donut Hole discount, you may find that you are paying more for your formulary drugs when you leave your Initial Coverage Phase and enter the Coverage Gap - depending on whether or not you were paying less than 25% of retail in your Initial Coverage Phase.

Jul, 13 2024 — You will pay $62.50 in the 2024 Donut Hole or Coverage Gap and $0 in the Catastrophic Coverage phase for all formulary drug purchases. Once the total retail value of your Medicare Part D drug purc . . .

Jul, 13 2024 — The Donut Hole Discount applies to the portion of a formulary drug's retail cost that carries over from the Initial Coverage phase and into the Coverage Gap.

Feb, 04 2024 — If you reach your Medicare Part D plan's Donut Hole, you will receive a 75% discount on all formulary drugs (generics and brand-name drugs). However, if your retail drug costs are about $230 per mo . . .

Sep, 01 2022 — Yes.  You will receive the discount directly at the plan's network Pharmacy. The Donut Hole discount on medications purchased in the Coverage Gap will be calculated at the point-of-sale (or Pharm . . .

Jul, 10 2023 — Yes, in 2010, the Congressional Budget Office forecasted a premium increase. The Congressional Budget Office (CBO.gov) issued the following statement: “The Patient Protection and Affordabl . . .

Jul, 06 2024 — Yes - but only the 70% pharmaceutical manufacturer discount for your brand-name formulary drug purchases. If your Medicare Part D plan (PDP) or Medicare Advantage plan (MAPD) includes supplemental . . .

Mar, 13 2022 — All brand-name Medicare Part D drugs.  According to the Affordable Care Act, only those brand drugs from manufacturers who have agreed to participate in the Doughnut Hole discount program can be . . .

Aug, 28 2022 — No. The 75% Donut Hole discount, does not apply to Medicare Part D excluded drugs even if they are covered by the Medicare Part D prescription drug plan as a “Bonus Drug” (also known as &# . . .

Jul, 08 2024 — Yes.  All Medicare Part D prescription plan offer the 75% Donut Hole discount - but, a few Part D plans (PDPs) and Medicare Advantage plans (MAPDs) also offer some form of additional supplementa . . .

Jul, 09 2023 — Around $1,920.  2011 marked the first year that you could receive a discount on medications purchased when you are in the Donut Hole (or Coverage Gap) portion of your Medicare Part D prescription . . .

Jul, 13 2024 — You will receive a 75% discount on all formulary drug purchases.   When purchasing Medicare Part D drugs in the Coverage Gap, the formulary drug tier (such as a Tier 5 Specialty Drug) does n . . .

Mar, 13 2022 — No.  The Donut Hole discount only applies to medications that are included on your plan’s formulary. If you wish to have your non-formulary medication covered by your Medicare Part D pla . . .

Sep, 01 2022 — No.  The manufacturer discount on brand-name drugs purchased in the Coverage Gap (or Donut Hole) is applied AFTER the plan’s supplemental coverage - and since the Programs of All-Inclusiv . . .

Aug, 16 2022 — No.  Medicare changed positions on this policy and first provided Donut Hole discounts for compounded Medicare Part D drugs in May 2010: "Part D sponsors shall only provide a discount on a compo . . .

Jul, 13 2024 — No.  Only Medicare Part D prescription drugs found on your formulary qualify for the brand-name or generic 75% Donut Hole discount. Non-formulary medications, over-the-counter (OTC) drugs, and . . .

Sep, 09 2024 — Yes, you are responsible for the copayment of the formulary drug purchase in the Initial Coverage phase - plus - the cost-sharing on the amount of the purchase price that exceeds your Medicare Part D . . .

Jul, 13 2024 — Both.  When you purchase your medications, the retail cost of your drug can move you from one part of your Medicare Part D plan coverage into another part. When this occurs and your prescripti . . .

Jul, 13 2024 — No.  Only Medicare Part D prescription drugs found on your formulary qualify for the brand-name or generic 75% Donut Hole discount. Non-formulary medications, over-the-counter (OTC) drugs, and . . .

Jul, 13 2024 — The Donut Hole Discount applies to the portion of a formulary drug's retail cost that carries over from the Initial Coverage phase and into the Coverage Gap.

Jul, 13 2024 — You will pay $62.50 in the 2024 Donut Hole or Coverage Gap and $0 in the Catastrophic Coverage phase for all formulary drug purchases. Once the total retail value of your Medicare Part D drug purc . . .

Jul, 13 2024 — You will receive a 75% discount on all formulary drug purchases.   When purchasing Medicare Part D drugs in the Coverage Gap, the formulary drug tier (such as a Tier 5 Specialty Drug) does n . . .

Jul, 08 2024 — Yes.  All Medicare Part D prescription plan offer the 75% Donut Hole discount - but, a few Part D plans (PDPs) and Medicare Advantage plans (MAPDs) also offer some form of additional supplementa . . .

Jul, 06 2024 — Maybe. Even with the 75% Donut Hole discount, you may find that you are paying more for your formulary drugs when you leave your Initial Coverage Phase and enter the Coverage Gap - depending on whether or not you were paying less than 25% of retail in your Initial Coverage Phase.

Jul, 06 2024 — Yes - but only the 70% pharmaceutical manufacturer discount for your brand-name formulary drug purchases. If your Medicare Part D plan (PDP) or Medicare Advantage plan (MAPD) includes supplemental . . .

Jun, 19 2024 — Yes, if you consider the 75% Donut Hole discount that you receive for any formulary drug purchased during the Coverage Gap or Donut Hole.  In addition, a few Medicare drug plans may also offer a . . .

May, 24 2024 — 95% of your brand-name drug's retail cost is counted toward exiting the Donut Hole. If your monthly purchases of formulary medications consistently have a retail value of over $420, you will ex . . .

May, 24 2024 — You will receive a 75% discount on all formulary drugs if you reach the Donut Hole or Coverage Gap. Changes coming to the Medicare Part D Donut Hole. Spoiler Alert:  In 2025, the Inflation Re . . .

Feb, 04 2024 — If you reach your Medicare Part D plan's Donut Hole, you will receive a 75% discount on all formulary drugs (generics and brand-name drugs). However, if your retail drug costs are about $230 per mo . . .

Jul, 24 2023 — Yes. The 75% Donut Hole discount is applied automatically at all network pharmacies when you buy formulary Medicare Part D medications while in the Coverage Gap. For instance, you will see a 75% . . .

Jul, 10 2023 — Yes, in 2010, the Congressional Budget Office forecasted a premium increase. The Congressional Budget Office (CBO.gov) issued the following statement: “The Patient Protection and Affordabl . . .

Jul, 09 2023 — Around $1,920.  2011 marked the first year that you could receive a discount on medications purchased when you are in the Donut Hole (or Coverage Gap) portion of your Medicare Part D prescription . . .

Sep, 01 2022 — No.  The manufacturer discount on brand-name drugs purchased in the Coverage Gap (or Donut Hole) is applied AFTER the plan’s supplemental coverage - and since the Programs of All-Inclusiv . . .

Sep, 01 2022 — Yes.  You will receive the discount directly at the plan's network Pharmacy. The Donut Hole discount on medications purchased in the Coverage Gap will be calculated at the point-of-sale (or Pharm . . .

Aug, 28 2022 — No. The 75% Donut Hole discount, does not apply to Medicare Part D excluded drugs even if they are covered by the Medicare Part D prescription drug plan as a “Bonus Drug” (also known as &# . . .

Aug, 16 2022 — No.  Medicare changed positions on this policy and first provided Donut Hole discounts for compounded Medicare Part D drugs in May 2010: "Part D sponsors shall only provide a discount on a compo . . .