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What is the Medicare Coverage Gap?

The Medicare coverage gap, also known as the Donut Hole, is a prescription drug coverage gap inside of your Part D plan. It’s a period of the year when your prescription drug costs can be higher than they were earlier in the year due to your spending.

What do I do if I hit the Medicare Coverage Gap?

Unfortunately, switching Medicare plans will not help you avoid hitting the Donut Hole. If you find yourself in the Donut Hole, it may be time to talk with your doctor about other prescription medication options. In many cases, he or she may be able to prescribe other generic medications.

Are there subsidies available for low income individuals?

Yes, certain people with low incomes and limited assets may qualify for the low-income subsidy, called Extra Help for Part D. If you qualify, Medicare will waive the gap for you. Your ordinary copays on your prescriptions will decrease quite a bit. You can apply for the subsidy at your local Social Security office, online or call us for help.

Will a Medicare Advantage plan cover a coverage gap in the Donut Hole?

In some plans and in some instances, yes. If you enroll in a Medicare Advantage plan, you may qualify for coverage through the Donut Hole in some circumstances. Speak to an Ivonne Welch Medicare Specialist to learn more.

Questions About the Coverage Gap?

An Ivonne Welch Medicare specialist is here to offer free assistance.

Call Ivonne Welch Insurance Agency at 1-800-324-4420, TTY 711

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