Key Takeaways

  • The Part D coverage gap (or "donut hole") officially closed in 2020, but that doesn't mean people won't pay anything once they pass the Initial Coverage Period spending threshold.

  • See what your clients, the drug plans, and government will pay in each spending phase of Part D.

  • Our infographic explains the different phases of coverage in 2023.

Medicare beneficiaries will see a Part D deductible up to $505 in 2023, followed by an Initial Coverage Period in which they will be responsible for 25% of costs up until they reach the threshold of $4,660 spent on prescription medications.

The Part D coverage gap (or "donut hole") officially closed in 2020, but that doesn't mean people with Medicare won't pay anything once they pass the Initial Coverage Period spending threshold. As this chart illustrates, total out-of-pocket costs will need to reach $7,400 before a beneficiary reaches the Catastrophic Benefit Period.

Our infographic explains who (people with Medicare, plans, or the government) pays what in the different phases of coverage in 2023.

Changes to drug spending caps resulting from passage of the Inflation Reduction Act will begin to phase in over the next few years.

Looking for the Part D cost-sharing chart that explains more about these levels of costs? Find it here.