Key Takeaways
- The coverage gap begins after you and your plan reach a spending limit.
- You pay a larger share of drug costs while in the gap.
- You leave the gap once you reach catastrophic coverage.
The coverage gap, often called the “donut hole,” is a phase in Medicare Part D where you temporarily pay a larger share of your prescription costs. It begins after you and your plan have spent a set amount on covered drugs.
Once your out-of-pocket spending reaches the catastrophic threshold, the gap ends and your costs drop sharply for the rest of the year.