The coverage gap, also known as the “donut hole,” is triggered once your aggregate expenses with your Part D insurer hit $4,430 (as per the 2022 figure) on eligible medications. Should your plan include a deductible, the full sum you expend towards meeting this deductible will count towards this $4,430 threshold leading into the coverage gap. Absence of a deductible in your Part D plan doesn’t alter the cumulative $4,430 threshold required to enter the coverage gap. What does alter is the proportion you contribute versus what your Part D plan contributes to reach the $4,430 mark that initiates the coverage gap.
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