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Some major changes in 2025 include a new $2,000 out-of-pocket max under Part D, eliminating the plan’s “donut hole” coverage gap, and fewer Medicare Advantage 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 ...
Will Medicare's so-called "donut hole" still exist? No, according to Medicare. "Because of the prescription drug law, the coverage gap ends on Dec. 31, 2024," its website states .
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.
Prior to 2010, enrollees were required to pay 100% of their retail drug costs during the coverage gap phase, commonly referred to as the "doughnut hole.” Subsequent legislation, including the Affordable Care Act, “closed” the doughnut hole from the perspective of beneficiaries, largely through the creation of a manufacturer discount program.
The Medicare Part D coverage gap (commonly called the "donut hole") will be completely phased out and hence closed. [151] The "Cadillac Tax" (originally scheduled to take effect on January 1, 2018) will go into effect. [152] (repealed in late 2019 before taking effect)