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The Doughnut Hole (Part D Coverage Gap)

Expenses Which Do And Do Not Count While You Are In The Doughnut Hole

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While you are in the doughnut hole, the following costs do count toward your catastrophic limit:

  • The costs of all the drugs you purchase which are on the plan's Formulary
  • Any costs for drugs on the plan's formulary which are paid for you by a third party such as a friend, family member, charity, or state pharmacy assistance program.

The following costs do not count toward your catastrophic limit:

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