What is the coverage gap?

Medicare prescription drug coverage has three different phases of coverage — initial coverage, the coverage gap and catastrophic coverage.

Initial Coverage

During initial coverage, your prescription drug coverage works like health insurance. Once you meet your deductible (if applicable), you pay copayments/coinsurance for your drugs based on what tier they fall under, and we pay the rest.

Talk to your doctor about generic drugs for extra savings, or look at ways to save on our plans.

The Coverage Gap

If you have Medicare prescription drug coverage, you enter the Coverage Gap when your total yearly drug costs, both what you and your plan paid, reach a certain amount. During this time, you pay most of your drug costs. Also called the "Prescription Drug Donut Hole."

Catastrophic Coverage

When you reach this annual prescription spending amount, you don't pay anything for your Part D covered drugs.

If you are receiving Extra Help, you won't enter the coverage gap.