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Pay for enough prescriptions to reach catastrophic coverage - Retiree

Posted: Nov 12th, 2021 - 2:21 pm In Reply to: How do you get out of the donut hole? - SOS

To get out of the coverage gap (what was called the doughnut hole) of your Medicare Part D drug plan, you or others on your behalf need to spend enough to get into the next category, catastrophic coverage. You should have received information from the drug plan at the beginning of the year explaining this, and you should receive statements every month or two outlining what prescriptions have been filled, the amount paid by you, the amount paid by the plan, and so on. These statements explain how much more needs to be spent to reach the next level. Using discount cards at the drugstore outside of your Medicare Part D plan does not count toward your Part D plan and reaching the next level. Right now it is open enrollment. Maybe the plan you have right now is not the best choice for you. You can compare plans at medicare.gov and perhaps choose a new one for next year.

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