Medicare Part D Coverage Gap Calculator
Medicare Part D Coverage Gap
Estimate your Medicare Part D out-of-pocket costs including the coverage gap
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Formula
Out-of-Pocket = Deductible + Copays in Initial Period + 25% in Gap + 5% in Catastrophic
Frequently Asked Questions
What is the Medicare Part D coverage gap?
The coverage gap (donut hole) begins after you and your plan have spent a combined amount on drugs, and you pay 25% of costs until reaching the catastrophic threshold.
When does catastrophic coverage begin?
Catastrophic coverage starts after your true out-of-pocket spending reaches approximately $8,000, after which you pay minimal costs.