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Medicare Glossary

Donut Hole (Coverage Gap)

Historically, a phase of Part D drug coverage with higher cost-sharing. Eliminated as of 2025. The 2026 Part D out-of-pocket cap of $2,100 effectively replaces it.

What it means

Historically, a phase of Part D drug coverage with higher cost-sharing. Eliminated as of 2025. The 2026 Part D out-of-pocket cap of $2,100 effectively replaces it.

Why it matters for Ohio beneficiaries

Whether you're new to Medicare in Ohio or comparing plans during AEP, terminology like "Donut Hole (Coverage Gap)" comes up repeatedly in Medicare paperwork, agent conversations, and the Medicare.gov Plan Finder. Knowing what it means helps you make decisions without getting lost in jargon.

Where to learn more

Looking for personalized help understanding how this applies to your specific situation? A licensed Ohio Medicare agent can walk through it with you — free of charge. You can also call OSHIIP (Ohio's free Medicare counseling program) at 1-800-686-1578, or browse our decision guides.

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