The ”Donut Hole” Explained

If you're looking into Medicare you have heard about the "Donut Hole"... Check out this short episode breaking down what the Donut Hole is and how it works. For all things turning 65 give our channel a subscribe click. We will help you navigate this new chapter in your life from Medicare to Car insurance and everything in-between. Remember our services our free to you ALWAYS! No matter where you are in the USA give us a call and we can help you answer any questions you might have. https://tcarrassociates.com/ Call us as: 810.534.3008 Thanks for joining us for another episode of unlocking Medicare. I'm your host Tyrone Carr. Today, we're gonna talk about the donut hole inside of the part D drug plan. Now, in order to reach the donut hole, you pay a combined cost between you and the drug plan of $4,430. Once you enter the donut hole, you will pay 25% for name brand medications, but also for generic medications. Now, in order to get out of the donut hole, you have to pay between the $4,430 up to $7,050. Now it's what you pay and what the drug plan pays combined. So you're not absorbing the difference of that $3,000. It's what you pay combined with the manufacturer. Once you've reached the $7,050, then you've entered into the catastrophic phase. Now, if you've reached the catastrophic phase, you know, the middle of December, January 1st comes, then the plans coverage starts over the beginning of the year. If you enter the donut hole and you're still in the donut hole and the end of the year comes December 31st, and now it's January 1st. The plan then is gonna start over. So it's either you've gone through the donut hole or the year end has come, and then the plan starts over. So in the donut hole again, it's you pay 25% of the name brand medications, 25% of the generic medications inside the donut hole. When it comes to generic, only the 25% of what you pay gets applied towards the $7,050. Not the actual manufacturer's cost. It only applies to the name brand. So if it's a name brand, it's what you pay and what the drug plan pays gets applied towards the $7,050. And that's the donut hole. Thank you for watching this video. If you enjoy your videos, hit the subscribe button below and stay tuned for upcoming videos. We post new ones, Monday, Wednesdays, and Fridays. And again, thank you for watching and we'll talk to you soon.