On January 1st, your Medicare Part D plan will start over - and you will no longer be in the Coverage Gap.
If your Medicare Part D plan has an
initial deductible, you will need to pay the initial deductible before reaching the
initial coverage phase (although some Medicare plans have provided
coverage of low-costing Tier 1 and Tier 2 drugs while in the initial deductible).
If your Medicare Part D plan does not have an initial deductible, you will be start your plan year in your Medicare Part D plan's initial coverage phase.
Once you reach the
Initial Coverage Limit (for example,
$4,660 in 2023 and
$5,030 in 2024), you will go into the Coverage Gap or Donut Hole and receive the
Donut Hole discount.
Depending on your medication use, it is possible that you will reach your out-of-pocket limit (for example, $7,400 in 2023 and
$8,000 in 2024) and continue into the
Catastrophic Coverage portion of your Medicare Part D plan coverage.
You can also use our online Donut Hole Calculator to visualize your Donut Hole exposure.
To help you visualize how far you are from the Coverage Gap, you can also try
our
Donut Hole Calculator where you enter the monthly retail value of your
medications and see a chart of your costs across the Part D coverage phases. Our Donut Hole Calculator can be found at:
PDP-Planner.com. (The Donut Hole discount calculations can be
found at the bottom of the chart.)
For more tips, please see our FAQ "
How will I know if - or when I reach my Medicare Part D plan's Donut Hole or Coverage Gap?"