What is the Medicare part D “coverage gap?”
The Medicare Part D coverage gap is a temporary suspension of benefits. In 2007, when a Part D beneficiary AND his/her prescription drug plan have spent a combined total of $2,400 on covered prescription medications, Part D coverage stops. The suspension of benefits continues until the beneficiary has spent another $3,021 on prescription medications. Senior Rx will cover all of an eligible members prescription drug costs during this gap as long as the medications are on the formulary (preferred drug list) of the members Part D plan and all requirements for prior authorization and step therapy are met. Senior Rx coverage will end and Medicare Part D catastrophic coverage will begin when the $3,021 target is reached.
The Medicare Part D coverage gap is a temporary suspension of benefits. In 2010, when a Part D beneficiary AND his/her prescription drug plan have spent a combined total of $2,830 on covered prescription medications, Part D coverage stops. The suspension of benefits continues until the beneficiary has spent another $4,550 on prescription medications. Senior Rx will cover all of an eligible members prescription drug costs during this gap as long as the medications are on the formulary (preferred drug list) of the members Part D plan and all requirements for prior authorization and step therapy are met. Senior Rx coverage will end and Medicare Part D catastrophic coverage will begin when the $6, 447.50 target is reached.
