Prescription savings guide
What Is the Medicare Part D Donut Hole?
Last updated August 9, 2026 · Reviewed by the LowerScript editorial team · Español
The Medicare Part D "donut hole" is a coverage-gap phase in which you may temporarily pay a larger share of your medication costs after you and your plan have spent a certain amount. During this phase, a discount-card cash price can sometimes be lower than your plan's cost — so it's worth comparing both at the pharmacy.
How the phases work
Part D has stages: deductible, initial coverage, the coverage gap ("donut hole"), and catastrophic coverage. Your share of costs changes between phases.
The 2026 Part D numbers
For 2026, Medicare's final program rules set the standard deductible at $615 and the annual out-of-pocket threshold at $2,100 (up from $2,000 in 2025) — once your true out-of-pocket drug spending reaches that threshold, Part D cost-sharing drops to $0 for the rest of the year (your premium still applies). 2026 is also the first year negotiated prices apply to the initial 10 drugs selected under Medicare's drug-price negotiation program. These numbers change annually — always confirm the current year's figures at Medicare.gov or with your plan. [Source: CMS CY2026 program rules; figures re-verified at Medicare.gov, 2026-08-02.]
Looking ahead to 2027
CMS has finalized the 2027 numbers too: the standard deductible rises to $700 (from $615) and the annual out-of-pocket threshold rises to $2,400 (from $2,100). CMS is also ending the temporary subsidy that held down some stand-alone Part D premiums in 2025–2026 — see our full guide, Medicare Part D premiums in 2027, for what that means and what to do this fall. 2027 plan details become available October 1, 2026, with enrollment opening October 15. [Source: CMS CY2027 Rate Announcement, Apr. 2026.]
Where a discount card fits
During the gap, comparing your plan price against a discount-card cash price can reveal savings. Remember, discount-card purchases don't count toward your Part D out-of-pocket totals.
Learn more
See Medicare prescription discounts in Florida, and check Medicare.gov for current program details.
Frequently asked questions
Does everyone hit the donut hole?
No — it depends on your total drug spending for the year.
Can a discount card help in the donut hole?
Yes, when its cash price is lower than your plan's cost for a drug. Compare both.
Do discount-card purchases count toward catastrophic coverage?
No, they don't count toward your Part D out-of-pocket totals.
This guide is general information, not medical, legal or financial advice. Always talk to your doctor or pharmacist about your medications. LowerScript is a discount program, not insurance.
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