Are there any Medicare Part D plans without a donut hole?
Asked by: Asa Klein V | Last update: August 21, 2025Score: 4.3/5 (36 votes)
Do all Part D plans have a donut hole?
Is there any insurance that covers the Medicare donut hole? While the federal government has shrunk the coverage gap, currently there aren't any Medicare Part D plans without a donut hole, even those included as part of a Medicare Advantage plan.
How do I avoid the Medicare donut hole?
Discuss lower-cost drug alternatives with your healthcare professionals. Seek out discounts on medications. Choose generic drugs over brand-name drugs. Opt for in-network pharmacies only.
Does SilverScript have a donut hole?
Drug tiers indicate the level of cost-sharing for a covered drug with beneficiaries typically paying lower copays for drugs in lower tiers. SilverScript Plus is an enhanced plan that provides additional coverage in the Coverage Gap (or Donut Hole).
Does Humana have a donut hole?
Coverage gap stage | Donut hole – $5,000
The coverage gap begins after you and your plan have spent $3,750 for covered drugs and ends when you have spent $5,000 for the covered drugs. In this phase—a gap in prescription drug coverage—you'll generally pay more for your drugs.
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Which is better, SilverScript Choice or Plus?
Best for prescription vitamins and minerals: Aetna
SilverScript Choice: This mid-range plan offers a lower copay for Tier 1 drugs at preferred pharmacies. SilverScript Plus: This plan is the most expensive one Aetna offers.
Does GoodRx count towards the donut hole?
Avoid falling into the Medicare donut hole too soon
You can use your Medicare plan for your more expensive brand drugs, and use GoodRx to purchase your less expensive generic medications. The cost of drugs purchased under GoodRx will not count against your coverage limit - thus keeping you out of the donut hole longer.
What is the maximum out-of-pocket for Part D in 2024?
Whether you're taking only brand-name drugs or a mix of brand-name and generic drugs, most people who reach the catastrophic coverage phase in 2024 will pay between $3,300 and $3,800 in out-of-pocket costs. In 2024, Mr. Alvarez takes $200,000 in Medicare Part D covered brand-name drugs.
What is the donut hole in social security?
Earnings above this threshold are not taxed for Social Security. The proposed reform suggests reinstating the payroll tax on incomes exceeding $400,000, creating a gap — or “donut hole” — between the current cap and $400,000 where earnings remain untaxed.
What happens to the Medicare donut hole in 2025?
The Inflation Reduction Act (IRA) signed by President Biden in 2022 will eliminate the Prescription Drugs Coverage Gap (known as the donut hole) for Seniors in 2025. Most Medicare drug plans have a coverage gap (also called the "donut hole").
What is the $2000 limit for Medicare Part D?
Thanks to the Inflation Reduction Act, in 2025 annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D.
Does UnitedHealthcare have a donut hole?
The coverage stage cycle starts over at the beginning of each plan year, usually January 1st. The Coverage Gap stage, or “donut hole,” is going away in 2025. You will now have 3 drug payment stages as part of your Part D benefit: Deductible, Initial Coverage, and Catastrophic Coverage.
How to shop for Medicare Part D plans?
Take your list to the Medicare Plan Finder at Medicare.gov. It can show you which Part D drug plans are available in your area and which of those plans cover your drugs. (You can also use the Plan Finder each year to check your current Part D plan and see if better options are available.)
What is the new Medicare rule for 2025?
Medicare Part D cap of $2,000
Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications.
Are there different Medicare Part D plans?
Are Medicare Part D Plans All The Same? While prescription drug plans provide at least the standard level of coverage as it is defined by Medicare, they have the option to offer different combinations of coverage and cost sharing.
Is Medicare getting rid of the donut hole?
In 2025, the Medicare Part D coverage gap, also known as the “donut hole,” will be eliminated under the Inflation Reduction Act (IRA). Part D plan members will also enjoy the security of an annual maximum out-of-pocket cost for prescription drugs.
What is the Medicare Part D premium for 2025?
The average estimated monthly Part D plan premium in 2025 is $46.50. Other factors can affect the cost of Part D including monthly premium, yearly deductible and copayments. High-income earners may pay a surcharge known as the “income-related monthly adjustment amount” (IRMAA).
Why are hospitals refusing Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Can I avoid the donut hole?
While it is not possible to completely avoid the Donut Hole in Medicare Part D prescription drug coverage, beneficiaries can take steps to reduce the amount of time they spend in this coverage gap.
Which is better, Medicare Part D or GoodRx?
Consider using a GoodRx coupon instead of Medicare in the following situations: Your medication isn't covered by your Medicare plan. The medication costs less with a GoodRx coupon than with your Medicare copay. You don't expect to reach your annual deductible.
How to get out of the donut hole?
- Lower the costs of your prescription medications by choosing a Part D plan with a formulary that includes your medications.
- Shop around to see if you can find a pharmacy that offers your medications at a lower cost.
How much is SilverScript a month?
SilverScript Choice PDP includes:
A monthly plan premium of $53.60. Tier 1 drugs for no more than $5* copay at all network pharmacies. A $590 deductible applies to all tiers.