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, you 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 you will be responsible for 25% of the cost of your drugs in the coverage gap this year. Although the donut hole has closed, you 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, you will be responsible for paying $25 (25% of $100) during the coverage gap.

Read Next: What Changes are Being Made in 2020 to the Costs of Medicare Part A (Hospital Insurance)?
Find Out: What Changes are Being Made in 2020 to the Costs of Medicare Part B (Medical Insurance)?
Return to: Medicare 2020

YourMedicare.com takes pride in providing you as much information as possible concerning your Medicare options, but only a health insurance broker licensed to sell Medicare can help you compare your plan options from various insurance companies. When you’re ready, we recommend you discuss your needs with a YourMedicare.com Licensed Sales Agent.

This content was created and copyrighted by the Medicare Rights Center ©2020. Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. These materials are presented here with support from YourMedicare.com and may not be distributed, modified or edited without Medicare Rights’ consent.