Who Is Impacted by the Donut Hole in Medicare Part D?


Quick Answer

People with Medicare coverage who are impacted by the "donut hole" are those who pay more than $2,800 out-of-pocket for drugs each year. There is a gap in which Medicare recipients are responsible for the full cost of drugs when they spend between $2,800 and $4,550.

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Full Answer

Some Medicare Part D plans have coverage in the donut hole, but they generally have higher premiums. As of March 2015, some assistance is available in the donut hole under the Affordable Care Act. A rebate of $250 is available, and there is a significant discount on prescription drugs while in this period. The donut hole is expected to be closed by 2020.

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