Does the Part D "donut hole" still exist?

No. It went away in 2025. A yearly out-of-pocket cap took its place.

More detail

You may still hear friends talk about the "donut hole." That was a stage where people suddenly paid much more for their drugs partway through the year. It's gone now.

Today, drug plans work in simple stages. You pay a deductible if your plan has one, then your share of each covered drug. Once your out-of-pocket costs reach the yearly cap, you pay nothing for covered drugs for the rest of the year. Payments made for you by programs like Extra Help count toward the cap too.

A mistake to avoid: thinking the cap means every drug is covered. Each plan has its own drug list, and plans can make changes to it. What you pay for a drug your plan doesn't cover doesn't count toward the cap.

Before you choose a plan each fall, have your current list of medicines, doses and pharmacies ready.

If an old article or a neighbor's story has you worried, call me and I'll explain how it works today.