Common Medicare Questions

Still have questions about Medicare? We can answer them for you. We receive questions every day from our clients, and have compiled a list of those we are asked most frequently. If you don’t see the answer to the questions that you have, contact us and we will speak to you personally!

What is the donut hole?

The Coverage Gap, or commonly referred to as the donut hole, is a stage of Part D plans that places an increased financial responsibility on the beneficiary. In 2018, when the cost of your medications passes $3,750, you will pay more for your medications until your costs reach $5000. After passing $5000 in costs, you enter-into the catastrophic stage, where your costs will reduce to significantly lower levels. For 2018, the donut hole cost share is 65% for most brand name drugs and 56% for generic drugs. In 2019, brand name drugs will increase to 75% cost sharing leaving the beneficiary to share 25% of the costs. For generic drugs, legislation today will close the generic donut hole in 2020.

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