What is the coverage gap? When does it begin and end?
Medicare drug coverage is divided into three phases. During Phase 1, you pay your standard copay amounts until your total drug costs – that includes the amount Peoples Health pays and the amount you pay, combined – reach $2,700. Phase 2 is the coverage gap. Peoples Health covers generic and preferred brand drugs through the gap, but you pay 100 percent of the cost for non-preferred brand and specialty drugs until your total out-of-pocket costs reach $4,050. After you have paid a total of $4,350, you will reach Phase 3, which is often called the “catastrophic coverage” period. During this phase, your drug copays will be $2.40, $6 or 5 percent, depending on the drug type. This three-step cycle starts over again at the beginning of each year.
