What is Happening to the Donut Hole (Coverage Gap) This Year?
The Medicare Part D donut hole or coverage gap is the phase of Part D coverage after your initial coverage period. You enter the donut hole when your total drug costs—including what you and your plan have paid for your drugs—reaches a certain limit.
In 2020, that limit is $4,020. While in the coverage gap, beneficiaries are responsible for a percentage of the cost of your drugs, and this percentage has decreased each year for the past several years.
The donut hole will close for all drugs in 2020. This means that beneficiaries will be responsible for 25% of the cost of their drugs in the coverage gap this year. Although the donut hole has closed, many may still see a difference in cost between the initial coverage period and the donut hole.
For example, if a drug’s total cost is $100 and you pay your plan’s $20 copay during the initial coverage period, beneficiaries will be responsible for paying $25 (25% of $100) during the coverage gap.