I've been dreading hitting the donut hole each year. How will its elimination in 2025 change what I pay throughout the year?

Answered by 3 licensed agents

With all the 2025 Medicare Plans & Prescription Drug Plans, once a person reaches $2000 in cost including 25% of the drugs cost towards the $2000, there is no more costs to the member, therefore, no more "donut hole"

Answered by Melonie Wood on April 4, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent
The annual out of pocket limit for all drug purchases is $2,000. The donut hole is not a factor.

The annual deductible applies toward the oop max.

Answered by James Carlson on April 8, 2025

Agent Licensed in MN

Answered by James Carlson Medicare Insurance Agent
You've been happy to learn that the donut hole has been abolished. This is a great savings for people who take a variety of different drugs. There is a $2000.00 maximum out-of-pocket through 2027 matter whether you take generic drugs or Brand Name drugs. Last year, folks paid a maximum of $8,050.00 in the donut hole and it has been replaced by the $2,000.00!! Medicare keeps track of your costs for you.

Don't forget that you have options with regard to paying for a copay for a drug. These are as follows: A) Making a copay for a prescription at your "Preferred" or in-network pharmacy when you have an Advantage plan, B) if you opted for a Medicare Supplement, along with a "Stand-Alone" Part D prescription drug plan, again going to a in-network preferred pharmacy can be your best choice, except for C) using an online discount pharmacy (like GoodRx.com, singlecare.com, costplusdrugs.com, etc., which can yield a better price than thru your Part D drug plan. That is an option; but you can only use one or the other for the same drug. Also, remember that if you've had success in the use of a Canadian online discount pharmacy, those out-of-pocket costs will no longer be applied toward that $2K deductible.

Answered by Steven Bleicher on April 6, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Tags: Medicare Part D Prescription Drug

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