My pharmacist mentioned the Medicare "donut hole" is going away in 2025. What does that actually mean for me?

Answered by 6 licensed agents

The "donut hole" (or coverage gap) in Medicare Part D prescription drug coverage is being eliminated in 2025, meaning once your out-of-pocket costs reach $2,000, you won't pay anything for covered medications for the rest of the year.

Answered by Melonie Wood on April 4, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent
The maximum out of pocket for prescription was reduced to $2000 a year. Once the $2000 has been met between you and your insurance company, your prescriptions would be covered. It will reset every year.

Answered by Yasmery Vargas on April 15, 2025

Agent Licensed in PA

Answered by Yasmery Vargas Medicare Insurance Agent
That means you are going to only be put of pocket $2000 before your drugs are at no cost.

It is a great reduction in Rx.

Answered by Rachael Metcalf on April 17, 2025

Agent Licensed in TN, FL, GA & 5 other states

Answered by Rachael Metcalf Medicare Insurance Agent
It

Means that your prices won’t go up through the year

You may have a deductible with your prescriptions

You can also apply for a leveling out program to keep your copays level through the year

Answered by Lowell Ryals on April 3, 2025

Broker Licensed in MO, AR, FL, KS, LA & TX

Answered by Lowell Ryals Medicare Insurance Agent
What this means is that you will likely spend less on your medications than you have in past years. For 2025 and beyond, the prescription drug plans will have a max out of pocket of $2000.

Answered by Aaron Young on April 8, 2025

Agent Licensed in OK, AR, GA & 6 other states

Answered by Aaron Young Medicare Insurance Agent
It means there is no longer a coverage gap that you are 100% responsible for paying. As long as your medications are covered on a carriers formulary, no matter how expensive the copay or retail cost may be, you have a maximum out of pocket on prescriptions of $2000 for the year.

Answered by Tommy Lawson on April 8, 2025

Broker Licensed in KY, CT & IN

Answered by Tommy Lawson Medicare Insurance Agent

Tags: Medicare Part D Prescription Drug

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