What is the Medicare Donut Hole??
The Medicare Part D coverage gap, generally known as the Medicare donut hole, "is the difference of the initial coverage limit and the catastrophic coverage threshold," as described in the Medicare Part D prescription drug program administered by the United States federal government.
After a Medicare beneficiary surpasses the prescription drug coverage limit, the Medicare beneficiary is financially responsible for the entire cost of prescription drugs until the expense reaches the catastrophic coverage threshold.
The donut hole comes as a nasty surprise to many seniors when they go abruptly from making copayments for their drugs to paying 100% of the cost. Clearly, this can make a huge dent into their pocket and may potentially result in seniors avoiding to purchase necessary medications due to financial reasons.