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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?
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 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.