Find Medicare Part D 2013 Changes, Medicare Donut Hole and Doughnut Hole Coverage Gapes along with Catastrophic Coverage Threshold. You can also check out:
Medicare Part D Donut Hole, Coverage and Changes 2013
Medicare comes in four parts A, B, C and D. Medicare Part D is most of the time referred to us doughnut hole due to the extraneous costs that it often comes with.

Medicare Part D was created in 2003 and only covers prescription drugs. This plan is available to all individuals who have either Medicare part A or B.

Medicare Part D Donut Hole

Medicare Part D coverage gap, commonly called Medicare Donut Hole, lies between the initial coverage limit and the catastrophic coverage threshold in the Medicare Part D prescription drug program by the United States Government.

Medicare Part D Donut Hole has been able to reduce the cost of prescription drugs for seniors by more than 13%. Medicare Part D Donut Hole is provided by private companies and not the federal government, you can buy part D as either a standalone or combined with A and B in Medicare advantage.

After a Medicare beneficiary exits the initial coverage of prescription-drug plan, the beneficiary is financially responsible for a higher cost of prescription drugs until he or she reaches the catastrophic-coverage threshold.

Medicare Part D Coverage

Medicare part D coverage works by one paying out of pocket monthly premiums per month, you will be required to pay 100% of your drugs until you reach $310 deductible amount. Ones you reach the deductible you will only pay 25% of the costs of your drugs while Medicare part D pays the rest. The Medicare will pay the rest till you and your plan reach $2800.

The doughnut hole sets in ones your drugs total more than the initial coverage limit and your part D will cease entirely. It is called the doughnut hole in the sense that regardless of one having an insurance and paying premiums one will not receive benefits for their medications. In this case a beneficiary is usually required to cater for all the costs of their prescription.

Medicare Part D Catastrophic Coverage

Catastrophic coverage will only kick in ones you spend another $3,610 on your drugs. Ones catastrophic coverage kicks in you will be required to cover only 5% of the costs of your drugs. There is a program called Medicare Extra Help that helps people pay their premiums and comes with reduced out of pocket costs for drugs.

Ones one reaches the donut level, financial challenges are most of the time known to set in, it are for this reason that the health reform law- the affordable care Act was enacted. This act helps in alleviating the burden of paying for the prescriptions ones you hit the donut level.

Medicare Part D 2013 Changes

Medicare Part D 2013 Changes for this year include, once you hit the donut hole you will be eligible for a onetime $250 rebate cheque. You will also receive a 50% discount on brand name drugs in the donut hole; you will also pay less and less for your generic part D drugs in the donut hole.

It is planned that as from 2020 the coverage gap will have been closed such that there will be no donut hole. In this case you will only pay 25% of the cost of your drugs until you reach the spending limit. You will also get continuous Medicare coverage throughout this time for your prescriptions as long as you are in the prescription drug plan

There is no need to keep track of your retail drug costs or retail drug spending, your Medicare part D plan provider will gather all the retail costs and keep a keen track of your record till you reach the donut hole Phase. You can also check out:

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  1. Hello. I found this article to be very helpful in understanding the gap created in Medicare part D. I did however wish to just correct an error in the writing. The word ones is used throughout the text but the correct word should be once. It would make the article appear more scholarly to use the correct grammar.


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