As of January 1, 2025, the donut hole departed as the $2,000 cap entered. Read more about the cap here and review the following information if you're interested in history.
Five facts about the now-departed Medicare Donut Hole
- The Medicare donut hole is actually the payment stage of Medicare Part D prescription drug coverage, officially known as the Coverage Gap. Once total drug costs reach $4,430 in 2022, the individual is in the donut hole.
- Those who reach the donut hole will be responsible for 25% of drug costs until they reach a total of $7,550 in out-of-pocket costs for that benefit year and then it's on to the last stage.. (Learn about discounts in the Coverage Gap.)
- In the Catastrophic Coverage stage, as of January 1, 2024, there were no costs.
- Those who take three to four or more brand-name drugs can reach this stage. Only three percent of Medicare beneficiaries ever reach the stage of Catastrophic Coverage.
- Your best bet to avoid the donut hole is to take good care of yourself and take generic medications whenever possible.
Learn even more about the Medicare donut hole with our free infographic.
Last updated: 12-05-2024