when some Medicare Part D patients fall into the dreaded "donut hole"
It's the time of year when some Medicare Part D patients fall into the dreaded "donut hole."
The "donut hole" is a gap in drug coverage that occurs when patients go over $2500/yr in drug costs. Once they've entered this gap, coverage resumes only after patients pay $3000 out-of-pocket.
For example, a patient may be accustomed to paying $25 a month for brands and $10 a month for generics on their Medicare D plan. Once this patient reaches their $2500/year limit with some plans, they'll have to pay the full cash price for ALL their meds for the rest of the year...until they've paid $3000 out-of-pocket. This can add up quickly for patients on a limited budget.