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Latest Medicare News on The Donut Hole or Coverage Gap

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Category: The Donut Hole or Coverage Gap

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An explanation of the 2017 Medicare Part D Coverage Gap or Donut Hole.
The Medicare Part D Coverage Gap or Donut Hole was actually similar to a second deductible in an insurance policy where, after receiving a certain level of coverage, you were responsible for paying yo ...

Where are the Medicare Part D Plans with COMPLETE Doughnut Hole Coverage?
Question:I enrolled in a 2007 Medicare Part D plan with NO Doughnut Hole.  My Part D plan pays for both my generic and brand name medications through the entire year!  This plan will save me ...

An explanation of the 2016 Medicare Part D Coverage Gap or Donut Hole.
The Medicare Part D Coverage Gap or Donut Hole is similar to a second deductible in an insurance policy where you are responsible for paying your own coverage after receiving a certain amount of insur ...

Another Doughnut Hole Dilemma - The Pros and Cons of Filling your Prescriptions Outside of Your Part D Plan
Doughnut Hole Question: What can I do if I am approaching the doughnut hole?  Am I allowed to fill my prescriptions outside of my Part D plan?  If I did this, I would avoid the doughnut ho ...

How much money could I possibly save with the 2016 Donut Hole Discount?
About $2,167.07 - maybe even a little more depending on your Medicare Part D plan. Your actual savings in the 2016 Donut Hole will depend on several things including: (1) How much you spent persona ...

Extra Help in the Doughnut Hole
We designed our online PDP-Planner or Doughnut Hole Calculator to help give Medicare Part D beneficiaries an idea when they will go into the Doughnut Hole or coverage gap.However, many people are alre ...

When You Purchase Meds Impacts Your Doughnut Hole Timing
Doughnut Hole Question:  What happens when we buy our prescriptions or medications in advance?  For instance, what occurs if we buy a three-month supply of medication through mail order?Answ ...

HHS Press Release: Medicare beneficiaries in donut hole will see 50-percent discount on brand name drugs in 2011
Vice President Joe Biden, the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS) today announced that the nation's pharmaceutical manufacturers wil ...

Probably Not a Good Idea: Cancelling Your Part D Plan Because You Hit the Doughnut Hole
Doughnut Hole Question:  I just entered the Coverage Gap last month.  Can I just drop my current Prescription Drug plan since there are no more benefits and then sign up again for 2008?  ...

No 2008 Medicare Part D Prescription Drug Plan offers Complete Brand-Name Drug Coverage in the Coverage Gap or Doughnut Hole - the Sierra Rx Plus Plan Will Not be Offerd in 2008.
No 2008  Medicare Part D prescription drug plan will offer complete brand-name and generic prescription drug coverage through the Doughnut Hole or Donut Hole or Coverage gap.The only 2007 Medicar ...

. Latest Items in Category


Understanding the 2018 Medicare Part D Coverage Gap or Donut Hole
If your formulary medications have a total retail value of over $3,750 or you have retail drug costs of over $313 per month, you will enter the 2018 Donut Hole and receive a discount on your Medic ...

What will I pay for my $250 brand-name drug when I reach the Donut Hole and Catastrophic Coverage phases of my 2017 Medicare Part D drug plan?
You will pay $100 in the Donut Hole or Coverage Gap and $12.50 in the Catastrophic Coverage phase for a brand-name drug with a $250 retail value.Once the total retail value of your Medicare Part D dru ...

Is the Medicare Part D Donut Hole any different if I am enrolled in a Medicare Advantage plan that includes drug coverage?
No.  If your 2017 Medicare Advantage plan includes prescription drug coverage (MAPD), then the Donut Hole or Coverage Gap portion of your coverage works just like a stand-alone Medicare Part D ...

In 2017, does the $4,950 out-of-pocket Donut Hole limit include the $3,700 Initial Coverage Limit so you only have to pay $1,250 ($4,950-$3,700) before leaving the Gap?
No.  Your $4,700 total out-of-pocket spending limit (2017 TrOOP) includes only the portion of your $3,700 Initial Coverage Limit that you actually paid for your medications - so, you cannot jus ...

If I only use one brand drug that costs $347 and has a $47 co-pay, will I enter the 2017 Donut Hole?
Yes. If your retail drug costs are $347 a month you will enter your Medicare Part D plan's 2017 Coverage Gap or Donut Hole in late-October or early-November 2017. As a reminder . . . You will en ...

Will you enter the 2017 Medicare Part D Donut Hole ... and if so, when?
You will enter your Medicare Part D plan's Donut Hole or Coverage Gap if the total retail value of your formulary prescription purchases exceeds your plan's Initial Coverage Limit, and the 2017 stan ...

An explanation of the 2017 Medicare Part D Coverage Gap or Donut Hole.
The Medicare Part D Coverage Gap or Donut Hole was actually similar to a second deductible in an insurance policy where, after receiving a certain level of coverage, you were responsible for paying yo ...

Do I just pay the difference between the $4,850 TrOOP and my $3,310 Initial Coverage Limit to exit the Donut Hole?
No.  Your $4,850 total out-of-pocket spending limit (2016 TrOOP) includes the portion of your $3,310 Initial Coverage Limit that you actually paid for your medications - but, you cannot subtrac ...

If I am already in the 2016 Donut Hole by May, is it cheaper to use a brand-name drug or the generic equivalent?
It depends. If you currently use Medicare Part D drugs with a retail cost of over $700 per month, you may be in the 2016 Donut Hole or Coverage Gap by mid- to late-May.While in the Donut Hole, you ...

An explanation of the 2016 Medicare Part D Coverage Gap or Donut Hole.
The Medicare Part D Coverage Gap or Donut Hole is similar to a second deductible in an insurance policy where you are responsible for paying your own coverage after receiving a certain amount of insur ...


Back To News Home . Browse All (39) Items in Category




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  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
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  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
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