Glossary
Coverage gap (donut hole)
The coverage gap — long known as the Part D "donut hole" — was a stretch of higher drug costs that kicked in after you and your plan had spent a set amount. It no longer exists in 2026: Part D now has a flat $2,100 yearly cap on what you pay out of pocket for covered drugs, after which you pay nothing more.
For years, Part D coverage paused in the middle of the year, leaving people to pay a larger share until they reached catastrophic coverage. A series of changes closed that gap, and for 2026 it is gone entirely.
In its place is a hard ceiling: once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for them for the rest of the year. Plans must also let you spread that cost into level monthly payments rather than paying it all at the pharmacy counter.
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