Donut Hole? Medicare Drug Plan Coverage Gaps

Most Medicare drug plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. You enter the coverage gap when your total drug costs—including what you and your plan have paid for your drugs—reaches a certain limit.

In 2024, that limit is $5,030. While in the coverage gap, you are responsible for 25% of the cost of your drugs.

A SHIP (SHINE) counselor can answer your Medicare questions and help you understand coverage and options!

To reach SHINE, call the Helpline at 866-413-5337.