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The Medicare Part D coverage gap (informally known as the Medicare donut hole) was a period of consumer payments for prescription medication costs that lay between the initial coverage limit and the catastrophic coverage threshold when the consumer was a member of a Medicare Part D prescription-drug program administered by the United States federal government.
Major changes in 2025 include Medicare Advantage plans and a new $2,000 out-of-pocket max under Part D, eliminating "donut hole" coverage gap.
Several changes are coming to Medicare Part D prescription drug plans in 2025 that could impact drug costs and plan coverage. One change is an annual $2,000 out-of-pocket cap.
Coverage gaps: Individuals move into the coverage gap once they have spent $5,030. The coverage gap is the phase that occurs after a person and their plan cover a certain amount of drug costs.
The federal government has been working to eliminate this gap and, according to Medicare, you’ll only pay 25% of the cost of covered medications when you’re in the coverage gap in 2024.
Quarters of coverage. Monthly premium 2025. Cost increase from 2024. at least 40 quarters. $0. $0. at least 30 quarters or married to somebody with at least 30 quarters
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