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Notice: During the government shutdown, continue using your 2025 health insurance plan and providers. Use this site to apply for and enroll in 2026 coverage during Marketplace Open Enrollment.

Donut hole (Medicare prescription drug)

Medicare drug plans previously had a coverage gap (also called the "donut hole"). The donut hole was a temporary limit on what the drug plan would cover for drugs.
Now all Medicare plans include a $2,000 cap on what you pay out-of-pocket for prescription drugs covered by your plan. If your out-of-pocket spending on covered drugs reaches $2,000 (including certain payments made on your behalf, like through the Extra Help program), you’ll automatically get “catastrophic coverage.” That means you won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.