The “donut hole” refers to a gap in coverage, during which you may have to pay more for your prescriptions drugs. Some members may have supplemental coverage to help lower prescription drug costs. Here’s a look at how the “donut hole” works:
Once you and your drug plan spend $3,750, you enter the “donut hole” or coverage gap.
While in the “donut hole,” you may pay 35% of the total cost of brand name drugs and 44% of the total cost of generic drugs until your total costs reach $5,000.
After you reach $5,000, your plan will contribute more toward your prescription drug costs.
* All dollar amounts reflect 2018 Medicare policies.
Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.
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