Archive: I use a brand-name drug, but this medication is not covered by my Medicare Part D plan. Will the brand-name discount still apply to this drug when I am in the Donut Hole?
Archive: Donut Hole Discounts · updated Mar 13, 2022
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.
You click here to see how the Donut Hole discount increases over the next few years until it is "closed" at a flat Donut Hole cost of 25% for medications.