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"Because of the prescription drug law, the coverage gap ends on Dec. 31, 2024," its website states. The so-called "donut hole," or coverage gap, has affected almost all prescription plans.
Here, you still pay 25% of the cost of all your drugs, until you get all the way through where the coverage gap used to be, according to Louise Norris, a health policy analyst for ...
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. 5 big changes to Medicare 2025 plans you should know ...
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.
This Coverage Gap phase is commonly referred to as "the Donut Hole." Beginning with the Affordable Care Act , cost-sharing in the Coverage Gap phase has been gradually reduced. Despite no longer triggering elevated cost-sharing, the Coverage Gap phase continues to exist for other administrative purposes.
The "donut hole" provision of the Patient Protection and Affordable Care Act of 2010 was an attempt to correct the issue. [23] In 2022, the Inflation Reduction Act removed this ban and allowed Medicare to begin negotiating drug prices starting in 2026. [24]
KFF, a nonpartisan health policy research organization, warns that some plans may adjust their premiums, formularies, copays or deductibles in response to the new $2,000 out-of-pocket spending cap.
Increasing tax credits to buy insurance; Eliminating several of the special deals given to senators, such as Ben Nelson's "Cornhusker Kickback" Lowering the penalty for not buying insurance from $750 to $695; Closing the Medicare Part D "donut hole" by 2020, giving seniors a rebate of $250.