The portion of the Part D benefit structure in which beneficiaries pay 100% of their Part D medication expenditures. The doughnut hole begins when total spending for drugs reaches $2,250, exclusive of the beneficiary's monthly premium, and it ends when total spending for drugs reaches $5,100 (generally equal to $3,600 in total out-of pocket spending for drugs). This is also called the "Coverage Gap."
A point in the Medicare prescription drug benefit where the consumer pays the full costs for their drugs. This occurs after reaching $2,250 in total drug costs, and the patient/consumer will pay 100% of drug costs until they reach $5,100.