Ans,
If you have traditional Medicare and have chosen a Part D plan (drugs), some of those plans have a donut hole. That means that after the plan pays a certain amount toward your prescriptions, you are in the donut hole and must pay for drugs yourself until you’ve spent a certain amount. Then, you are out of donut hole and plan resumes paying. It’s a terrible way to manage someone’s prescriptions and “donut hole” is a dumb name for it. All plans are different. I am on an Aetna plan that doesn’t have a donut hole.
We are currently in the Open Enrollment period. Until December 7. You can call Medicare 1-med-icar -
And they will go over your options with you. Different parts of the country have different plans. During Open Enrollment, they add a lot of staff to answer these calls and are available 24 hours a day. I always call at some odd time like Sunday at 8pm. No waiting. When you speak to them, they can tell you whether a plan has a donut hole and when it kicks in, what premium is, whether it has a deductible, and exactly what each one of your drugs will cost under each plan. In my state, there are 45 different plans this year (2024). I am only interested in hearing about the top 3-4 plans so that is what we talk about. This has become a lot easier in last few years because the Medicare person can now see what your drugs are - or what you’ve been buying - and what plan you’re currently on. They have a scary amount of information about you, but it makes this process easier.
You can ask them to tell you what plans do not have a donut hole Or don’t have a deductible. Sometimes, a person has one drug that’s very costly snd they can ask to search for a plan that covers it.
It’s worth the trouble to make the call and have the conversation. You are protecting yourself and educating yourself. Also, if you choose a Part D plan over the phone with Medicare, they can enroll you right then. They can change you from you current plan to a new one.