Frequently Asked Questions about Archive: The Donut Hole or Coverage Gap

May, 28 2024 — 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, 07 2024 — The Donut Hole or Coverage Gap is the third part or phase of your Medicare Part D prescription drug coverage where you will pay 25% of the retail price for any prescriptions found on your plan's formu . . .

Jul, 13 2024 — 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.

Jan, 21 2024 — 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 supplemental Donut Hole cover . . .

Jun, 04 2024 — 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 . . .

Jul, 13 2024 — 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 . . .

Jun, 04 2024 — On January 1st, your Medicare Part D plan will start over - and you will no longer be in the Coverage Gap. If your Medicare Part D plan has an initial deductible, you will need to pay the initial d . . .

May, 03 2023 — The Maryland Senior Prescription Drug Assistance Program (SPDAP) Coverage Gap Subsidy was discontinued in 2021.  Now, Maryland SPDAP will pay up to $50.00 per month for your Medicare Rx prescript . . .

Jun, 12 2024 — Only the retail cost of formulary drugs purchased with your Medicare Part D prescription drug plan count toward entering the 2024 Coverage Gap or Donut Hole.  Only your out-of-pocket drug spendin . . .

Jun, 08 2024 — 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 . . .

Jul, 10 2023 — 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 . . .

Apr, 17 2023 — Donut Hole Coverage or Gap Coverage, according to the Centers for Medicare and Medicaid (CMS) is defined as: After you have spent a certain amount of money for covered drugs, you have to pay all . . .

Feb, 04 2024 — 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 . . .

Jul, 13 2024 — 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 . . .

Jul, 13 2024 — Maybe.  Some Medicare Part D plans offer additional Gap Coverage (beyond the Donut Hole discount) to plan members reaching the Donut Hole or Coverage Gap.  If you are using generic drugs, yo . . .

Jun, 19 2024 — If your formulary medications have a total retail cost over $420 each month, you will exceed your 2024 Medicare Part D plan's $5,030 Initial Coverage Limit and enter the Donut Hole or Coverage Gap sometime before December 31st.

Jul, 13 2024 — Yes.  If your Medicare Advantage plan includes prescription drug coverage (MAPD), then the 2024 Donut Hole or Coverage Gap portion of your coverage works just like a stand-alone Medicare Part D . . .

Aug, 07 2024 — The Donut Hole or Coverage Gap is the third part or phase of your Medicare Part D prescription drug coverage where you will pay 25% of the retail price for any prescriptions found on your plan's formu . . .

Jul, 13 2024 — 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 . . .

Jul, 13 2024 — 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, 13 2024 — Maybe.  Some Medicare Part D plans offer additional Gap Coverage (beyond the Donut Hole discount) to plan members reaching the Donut Hole or Coverage Gap.  If you are using generic drugs, yo . . .

Jul, 13 2024 — Yes.  If your Medicare Advantage plan includes prescription drug coverage (MAPD), then the 2024 Donut Hole or Coverage Gap portion of your coverage works just like a stand-alone Medicare Part D . . .

Jul, 13 2024 — 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 . . .

Jun, 19 2024 — If your formulary medications have a total retail cost over $420 each month, you will exceed your 2024 Medicare Part D plan's $5,030 Initial Coverage Limit and enter the Donut Hole or Coverage Gap sometime before December 31st.

Jun, 12 2024 — Only the retail cost of formulary drugs purchased with your Medicare Part D prescription drug plan count toward entering the 2024 Coverage Gap or Donut Hole.  Only your out-of-pocket drug spendin . . .

Jun, 08 2024 — 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 . . .

Jun, 04 2024 — On January 1st, your Medicare Part D plan will start over - and you will no longer be in the Coverage Gap. If your Medicare Part D plan has an initial deductible, you will need to pay the initial d . . .

Jun, 04 2024 — 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 . . .

May, 28 2024 — 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 . . .

Feb, 04 2024 — 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 . . .

Jan, 21 2024 — 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 supplemental Donut Hole cover . . .

Jul, 10 2023 — 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 . . .

May, 03 2023 — The Maryland Senior Prescription Drug Assistance Program (SPDAP) Coverage Gap Subsidy was discontinued in 2021.  Now, Maryland SPDAP will pay up to $50.00 per month for your Medicare Rx prescript . . .

Apr, 17 2023 — Donut Hole Coverage or Gap Coverage, according to the Centers for Medicare and Medicaid (CMS) is defined as: After you have spent a certain amount of money for covered drugs, you have to pay all . . .