Archive: Which brand-name prescription drugs are eligible for the Coverage Gap or Donut Hole discount?

Archive: Donut Hole Discounts · updated 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 covered under the Medicare Part D program.

Therefore, all formulary brand-name drugs purchased in the Coverage Gap by non-LIS Medicare beneficiaries will get the discount. (People who are eligible for the Low-Income Subsidy or Medicare Part D Extra Help program will not have a Donut Hole in their coverage.)

The Doughnut Hole discount also applies to brand-name drugs coverage by a Medicare Part D plan under transition and emergency fill policies, as well as under formulary exceptions and appeals processes.

Any “Bonus Drugs” or “Supplemental Drugs” not covered under the Medicare Part D program, but covered by a specific Medicare prescription drug plan do not receive the Doughnut Hole discount (click here to read more).