The Donut Hole...(aka Medicare Part D coverage gap) begins after you and the plan together have spent $2,510 in total yearly drug costs.
At this point, you will pay 100% of your discounted prescription drug costs until you reach $4,050 in yearly true out-of-pocket drugs costs.
True out-of-pocket costs are your share of the prescription drug costs in a Medicare Part D plan; such as deductibles, copays (if applicable), and the amounts you pay in the coverage gap. It does not include monthly premiums.
The above condition is dictated by Medicare. It is not dictated by any insurance plan.
See Part 2 at this link
https://www.aarpmedicarerx.com/nine_...nk=Rcninefacts
I have the AARP MedeicareRX
Enhanced Plan, so during the coverage gap, I pay only the required copay for Tier 1 drugs/generic drugs.
"Castastrophic Coverage" is available if and when you reach the $4,050 limit. Once you reach catastrophic coverage, your plan will pay most of your drug costs until the end of the year.
For some of us...like me...it means that from April until Decemer 31st, I will pay 100% of all my brand drug costs. Fortunately, I am able to obtain samples from two of my doctors for Brand meds that are not yet available as generics, and I am using up leftover Mirapex from a friend in Arizone who no longer was taking them and had an abundance of .5 mg.