Is there any prescription coverage when an individual is in the “donut hole”?

Yes, however, the cost-sharing requirements are different. When a Medicare enrollee is in the Medicare Part D prescription drug coverage “donut hole,” they are required to pay up to 25 percent of the costs of their prescription drugs (both brand name drugs and generics). These costs will count towards their out-of-pocket maximum. When they reach their out-of-pocket maximum, they will exit the “donut hole” and transition to the catastrophic coverage phase of Medicare Part D coverage. Find more information about costs in the coverage gap on the CMS website.