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Home > Closing the Coverage Gap

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FAQ(s) found under  Closing the Coverage Gap Showing 11 of 21 Prev  |  Next

Does everyone receive a discount in the Coverage Gap?
Last Update : 2010-06-22 

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No.  Only Medicare beneficiaries enrolled in a Medicare Part D prescription drug plan (PDP) or a Medicare Advantage plan that offers a prescription benefit (MA-PD)

  • and who are not enrolled in a qualified retiree prescription drug plan
  • and are not entitled to an income-related subsidy (LIS)
  • and who have reached or exceeded the Initial Coverage Limit during the year
  • and have not yet entered the Catastrophic Coverage phase of their prescription drug plan coverage

    . . .will receive the discount.


Please note that enrollees in Employer group health and waiver plans may also eligible for participation in the Discount Program.



Related FAQs In This Category
•  My current prescription drug retail cost are $230 per month. What will be my discount in the Doughnut Hole?
•  What exactly is TrOOP or True Out of Pocket costs?


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Latest Added FAQs

• I use a brand name drug, but it is not covered by my Medicare Part D plan. Will the 50% discount on brand-name drugs still apply to this drug when I am in the Donut Hole?

   No.  The Donut Hole discount only applies to medications that are included on your Medicare pr...
   Last Update : 2011-05-16


• I asked my pharmacist about the new discount program and he did not seem to know anything about it. So will I still receive this 50% discount on my refills while I am in the doughnut hole or do I need to find another pharmacy?

   Complete Question: I use one expensive medication that cost almost $2000 a month and I have already ...
   Last Update : 2012-09-29


• Does the Donut Hole Discount apply to a retail drug purchase that straddles my Medicare Part D plan's Initial Coverage phase and the Coverage Gap or Donut Hole phase? In other words, does the Donut Hole discount apply to a Straddle Claim?
   Yes.  If the negotiated retail price of your medications moves you from the Initial Coverage ph...
   Date Added : 2011-03-08    


• How much do I have to pay for generics in the donut hole in 2011, 2012, 2013,2014, 2015, etc. until it reaches 25%
   Even if your Medicare Part D plan has no coverage in the gap, starting in 2011, you receive a disco...
   Date Added : 2010-09-23    


• For 2011 you indicate that the full retail cost of drugs while in the donut hole will apply to the amount required to get out for name brands even though I'm only paying 50%. Can you clarify?
   Complete Question: For 2011 you indicate that the full retail cost of drugs while in the donut hole ...
   Last Update : 2012-09-29




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