Medicare Donut Hole

The Donut Hole is the coverage gap that occurs when you and your Medicare drug plan have reached a pre-determined spending limit for covered drugs and you begin to pay for your drugs "out-of-pocket." For example, in 2020, once you have spent $4,020 on covered drugs, you enter the coverage gap.

While in this coverage gap, you will pay no more than 25 percent of the cost for brand-name drugs and generic drugs, out of pocket until you reach the catastrophic coverage point. This amount changes every year. In 2020, once your out-of-pocket spending reaches $6,350, you leave the donut hole and enter catastrophic coverage. Once you reach this point, coverage under your Medicare drug plan begins again and you pay only a small co-insurance or copayment for each prescription until the end of the year.

Medicare Prescription Drug Coverage Gap (Donut Hole)

Medicare Prescription Drug Coverage Gap (Donut Hole)

Speak with a licensed sales agent

1-800-637-7602TTY User 711 Mon-Fri 8:30a - 8:00p ET

The MedicareUSA website is operated by HealthPlanOne, LLC a licensed health insurance agency based in Connecticut; in California d/b/a HPOne Insurance Agency, license #OF30784. HealthPlanOne, is a licensed and certified representative of Medicare Advantage HMO, PPO and PPFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.

For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

Medicare supplement plans are not connected with or endorsed by the U.S. Government or the federal Medicare program.

The Centers for Medicare and Medicaid Services (CMS) does not review or approve Medicare Supplement plan information.

Last Updated 09/01/2019