Which statement about the Medicare Coverage GAP is true?

• A. The Coverage GAP was eliminated in 2020.
• B. It was eliminated in 2025.
• C. The Coverage GAP was eliminated in 2025.
• D. It remained in effect.

Answer: (C)

The key idea is how Medicare Part D handles costs over the year. There used to be a “coverage gap” (the donut hole) where you might pay most of your drug costs after reaching a certain point, before reaching catastrophic coverage. The important change came with the ACA: the donut hole was closed by 2020. During the gap, there’s a significant manufacturer discount on brand-name drugs and shared costs among you, the plan, and the sponsor that count toward the out-of-pocket threshold. Once your out-of-pocket costs (including those discounts) reach that threshold, you move into catastrophic coverage and pay only small amounts for covered drugs for the rest of the year. So, today there is no donut hole in the way there used to be; statements claiming elimination in 2025 or that it remained in effect are not accurate.