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In the current calendar year, seniors could enter the donut hole once they and their plans had spent more than $5,030 on drug costs, at which point they were on the hook for out-of-pocket drug ...
Major changes in 2025 include Medicare Advantage plans and a new $2,000 out-of-pocket max under Part D, eliminating "donut hole" coverage gap.
Starting in 2025, out-of-pocket drug spending will be capped at $2,000 per year and the prescription drug “doughnut hole” will be eliminated. Here’s how the new system will work:
The Medicare Part D coverage gap (informally known as the Medicare donut hole) was a period of consumer payments for prescription medication costs that lay between the initial coverage limit and the catastrophic coverage threshold when the consumer was a member of a Medicare Part D prescription-drug program administered by the United States federal government.
Plans can change the drugs on their formulary during the course of the year with 60 days' notice to affected parties. The primary differences between the formularies of different Part D plans relate to the coverage of brand-name drugs. Typically, each Plan's formulary is organized into tiers, and each tier is associated with a set co-pay amount.
Some major changes to Medicare Plan D in 2025 include an annual $2,000 out-of-pocket cap on drugs ... of coverage ‘donut hole’ ... things when shopping for a Medicare drug plan this year ...
These programs were known as "Medicare+Choice" or "Part C" plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the compensation and business practices for insurers that offer these plans changed, and "Medicare+Choice" plans became known as "Medicare Advantage" (MA) plans.
Officially, Medicare drug plans no longer have a donut hole—the gap between covered drugs and catastrophic coverage. This hole was gradually closed thanks to provisions in the Affordable Care ...