Archive: I use a brand-name drug, but it is not covered by my Medicare Part D plan. Will the discount on brand-name drugs still apply to this drug when I am in the Donut Hole?
Archive: Closing the Coverage Gap · updated Jul 25, 2019
If you wish to have your non-formulary medication covered by your Medicare Part D plan, you would need to ask for a Formulary Exception or Coverage Determination.
If your Medicare plan grants your request, your medication will be included on your own “personal” formulary and the Donut Hole discount would apply. If your formulary exception is denied, you can appeal your plan's decision.