Etini Willie
Active member
- Credits
- $2.92630
As you are co-paying for drugs in the initial coverage stage, Medicare is tallying your entire expenses on drugs. This is inclusive of what you pay and what the insurance company pays. If the amount a Medicare part d holder goes over a certain limit each year, the stage 3 of part D Medicare is triggered.
This is called the coverage gap. In the coverage gap, your insurance holder can charge you up to 25% of your brand-name drugs. The charge on your generic drugs is also at a slightly higher percentage.
The coverage gap is designed to encourage people to use generic drugs whenever possible. This is how it works.
Assuming the retail price of a drug is $400. And the initial coverage was 50%. However, the gap set by Medicare for instance was $100. 50% of $400 is $200. That is higher tthe han gap set by Medicare. At this point, the coverage gap would be triggered which lowers your liability for drugs to about 25%.
It is important that you liaise with your doctor to keep the cost of medication low so that the gap. would not be crossed.
So that's how the part d Medicare coverage gap works.
This is called the coverage gap. In the coverage gap, your insurance holder can charge you up to 25% of your brand-name drugs. The charge on your generic drugs is also at a slightly higher percentage.
The coverage gap is designed to encourage people to use generic drugs whenever possible. This is how it works.
Assuming the retail price of a drug is $400. And the initial coverage was 50%. However, the gap set by Medicare for instance was $100. 50% of $400 is $200. That is higher tthe han gap set by Medicare. At this point, the coverage gap would be triggered which lowers your liability for drugs to about 25%.
It is important that you liaise with your doctor to keep the cost of medication low so that the gap. would not be crossed.
So that's how the part d Medicare coverage gap works.
