Maybe.  Some Medicare Part D plans offer some additional Gap Coverage (beyond the Donut Hole discount) to plan members reaching the Donut Hole or Coverage Gap.  If you are using generic drugs, you will pay the plan's copay in the Donut Hole - and not receive the 75% Donut Hole discount.  However, if you are using brand-name drugs, you will receive a portion of the Donut Hole discount on top of the plan's Donut Hole copay.

Most Part D plans offering coverage during the Doughnut Hole only offer the Donut Hole coverage for limited drugs - in fact, a Medicare drug plan may only offer coverage for generic medications – and some of these plans charge a higher copayment for generics during the Coverage Gap.  Other Medicare Part D plan will provide limited generic and brand-name drug coverage through the Doughnut Hole or Coverage Gap, and you can see from the enrollment figures that only a fraction of beneficiaries enrolled in these plans.

When you may receive a benefit from a Part D plan with Donut Hole coverage:

1. You must have annual retail medication costs over your plan's Initial Coverage Limit ($4,660 in 2023 and $5,030 in 2024) or retail drug costs of over $389 each month and over $420 in 2024.
   
   
2. If you are enrolled in a Part D plan that provides generic coverage through the donut hole then you will receive a benefit if you are using a large number of generic drugs or rather expensive generic medications.
   
   
3. If you are enrolled in one of the few Part D plan that provides some brand-name and generic coverage and you use the drugs that are covered through the Doughnut Hole.

When you probably will not receive much of a benefit from your Part D plan that offers Donut Hole coverage:

1. If your annual retail prescription costs do not exceed, or only slightly exceed, your plan's Initial Coverage Limit.  For example, if your average monthly retail costs in 2023 of $390 or $430 in 2024, you will enter the Doughnut Hole in late-December, but you may pay a much higher monthly premium (triple as much as a Part D plan with no Doughnut Hole coverage).  So, the benefit of a few days of Doughnut Hole coverage will probably not justify a year of higher monthly premiums.
   
   
2. If you use only low-cost generics, you may be able to get the same negotiated prices at local retail pharmacies (such as WalMart) – even in the Doughnut Hole.
   
   

Historical Note:

In 2009, no Medicare Part D plan provides complete brand-name and generic drug coverage through the Doughnut Hole. See the types of Gap Coverage available in 2009 as compared to 2008.

Most 2009 Part D plans offering coverage during the Doughnut Hole only offered additional coverage for generic medications – and some of these plans charge a higher copayment for generics during the Coverage Gap. Only three (3) Medicare Part D plans (one in FL, one in WI and one in MI) provide limited brand-name drug coverage through the Doughnut Hole or Coverage Gap, and you can see from the enrollment figures that only a fraction of beneficiaries have enrolled in these plans.