The donut hole is a period of time when you pay out of pocket for your medications. It is a temporary limit on the amount that your Medicare plan pays for medications. In 2016, once you and your plan have paid $3,310, you enter the “donut hole” and remain until you and your plan have reached $4,850. Once you reach $4,850 you enter catastrophic coverage, paying a small amount for the rest of the year.
It is important for you to know which physicians are covered under your Medicare plan. Before getting any procedures or services, call the number on the back of the card to make sure they are covered. Know which medications are covered under your plan and which pharmacies are in your network. Evaluate your plan each year to see if it met your expectations. You may need to switch plans to better meet your needs.
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