Changes to 2022 Medicare Part D co-pays and donut…released!

Published 12:00 am Wednesday, October 13, 2021

This year, the 2022 Medicare and You handbook did not include all the information regarding
the Medicare Part D deductibles and “Donut Hole.” I got in the “famous” Medicare donut hole this August and do not know how I got there.
I know it is October, but I would like to get prepared and really cannot find the answer online
or at the website. Please inform me what are the 2022 Medicare Part D costs.
I look forward what you have to say. Cathy from St. Louis

You are correct that the 2022 Medicare and You handbook did leave information out
regarding the 2022 Medicare Part D deductibles or out of pocket maximums.
But guess what?? For the Toni Says® Medicare newspaper column readers, we have a
surprise! I know what the Medicare Part D cost, copays, and Donut Hole out of pocket will be
beginning January 1,2022.
2022 Medicare Part D costs and co-pays are explained below:
Part D changes for 2021 are:
Initial Deductible: will increase by $35 from $445 in 2021 to $480 in 2022.
Initial Coverage Limit: will increase by $300 from $4,130 in 2021 to ($4430 in 2022) where the 2022 “Donut Hole” begins.
Out-of-Pocket threshold cost: or ( TrOOP true out of pocket) will increase from $6,550 in 2021 to $7,050 in 2022.
Coverage Gap (Donut Hole): begins once you reach your Medicare Part D plan’s initial coverage limit $4,430 in 2022 and ends when you spend a total of $7,050 out-of-pocket in 2022.
What is the Donut Hole Discount?: Part D enrollees will receive a 75% Donut Hole discount on the total cost of their brand-name drugs purchased while in the Donut Hole. The discount includes, a 70% discount paid by the brand-name drug manufacturer and a 5% discount paid by your Medicare Part D plan. The 70% paid by the drug manufacturer, 5% Part D plan discount combined with the 25% you pay, count toward your TrOOP or Donut Hole exit point.
Generic and Brand Name Drug Donut Hole Co-Pay: when one reaches Medicare Part D Donut Hole: pay a maximum of 25% co-pay on generic or brand name drugs purchased while in the Coverage Gap.
Lower costs when one comes out of the Donut Hole and enters Catastrophic coverage which is $3.95 for generics under $79 and $9.85 brand name drugs under $197 or over these for generic and brand name drugs there is only a 5% cost for the prescription drugs until December 31and a new year begins. Then the Medicare Part D cycle begins again with a new deductible and co-pays on January 1 of every year.

Toni Says® Tips:
1) During Medicare’s Annual Enrollment Period from October 15 to December 7 be sure that all
prescriptions are covered by a new standalone Medicare Part D plan or a Medicare Advantage
plan with prescriptions which will begin January 1 .
2) Remember you will pay 100% of the cost if any prescriptions (generic or brand name) are not
covered on your Medicare Part D plan.
3) Talk to your doctor or doctors about which brand name drugs can be changed to generics.
4) Get samples from your doctor.
5) Call Toni Says Medicare Office at 832/519-8664 for Medicare Part D 2022 Prescription Drug
Do not forget…There is a penalty for not enrolling in a Medicare Part D Prescription Drug plan
when you first become eligible to enroll.

Toni King, Medicare author/advocate is giving a $10 discount to the Toni Says® readers on the
2021Medicare Survival Guide® Advanced book at or call 832-519-8664.