To assist you with better understanding your Part D plan, we have developed an online Doughnut Hole estimation tool that will show you approximately when you will enter the Doughnut Hole and help you understand the possible costs of your own personal Doughnut Hole or Coverage Gap.
(The Doughnut Hole or Coverage Gap is the part of your Medicare Part D prescription drug coverage when your total retail costs for prescription medications reach $2,400 and you may be required to pay 100% of your prescriptions until your retail cost of medications reaches $5,451.25.)The on this site Doughnut Hole Calculator is free to use and can be found at
on this site PartD-PartD CoverageGap Calculator 07Xphp.php
Remember: Our online Doughnut Hole calculator is still an estimate based on the CMS Standard Plan, but should provide some guidance for your 2007 prescription budget.
The Doughnut Hole Calculator allows you to
- Enter in your monthly, quarterly, semi-annual and annual prescription retail costs (before Part D coverage) – For example, if you purchase the same medications only once a month, then enter only monthly retail costs. (This monthly retail value should be available from your pharmacy or Part D plan). If you also purchase certain medication every three months, then enter your quarterly costs. If you purchase some medications only once a year, add those values to the annual cost box.
- If your Part D plan has an initial deductible, enter this initial deductible into the form. About 40% of Medicare Part D plans have an initial deductible where you pay 100% yourself before the beginning of your Part D benefits. The standard deductible for 2007 is $265.
- Choose the month in which your Part D plan began. If you had a 2006 Medicare Part D, your 2007 Medicare Part D begins in January. If you just began receiving your Part D benefits, select the starting month of your Part D plan.
- If you wish, you may also enter your monthly Part D premiums. This is an optional number that does not change your Doughnut Hole calculation, however if you enter this figure you will get a better idea of your total out of pocket prescription costs for 2007. The average monthly Part D premium for 2007 was $27.35.
- Click on the “Submit” button. Your personal information will not be shared with any third party.
- Your Doughnut Hole results are shown on the same page directly below the Doughnut Hole form. The colors show you whether you are in the initial deductible phase, the initial coverage phase, the Doughnut Hole, or the Catastrophic Coverage phase.
- Would you like a copy of your Doughnut Hole report? Enter your eMail address in the form at the bottom of the page and we will send you an eMail copy of your page. Your eMail information will not be shared with any other party.
Still not sure? Would you like to see some examples of the Doughnut Hole Calculator?
We also have provided a few examples of how to operate the Doughnut Hole Calculator:
- Example with Monthly retail costs of $800.
- Example with Quarterly retail costs of $2,400.
- Example of Monthly plus Quarterly prescription costs.
What does the Doughnut Hole mean to you?
If you know approximately when you are going into the Doughnut Hole and how much you will spend, begin preparing now.
For some Part D beneficiaries, the Doughnut Hole will prove to have a large financial impact on personal budgets. We designed our online Doughnut Hole calculator with the hope that it will at least show Part D beneficiaries when they should prepare to see increased prescription expenses.
Aside from adjusting your personal budget accordingly, you can explore possible generic alternatives. Try to speak with your physician(s) now and get an idea if they see any prescription changes on the horizon – check to see if these potential medications (or their generic equivalent) are also part of your new Part D plan’s formulary.
Also, if you have Veterans Administration benefits (or something similar), you may wish to see if any of your medications are available from the VA.