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Questions with the Keyword COVERAGE GAP
| Questions | Possible Answers |
|---|---|
| Would my premium amount be applied to the Coverage Gap? | The Medicare Part D coverage gap will be eliminated on January 1, 2025. Medicare Part D plans will have a $2,000 annual out-of-pocket limit for covered drugs. Once you reach the limit, we will pay 100% for covered drugs for the remainder of the year. |
| If my mother reaches the Coverage Gap, will she get her discount at the pharmacy or does she have to submit a form for the discount? | Same as above |
| Does your plan have any additional drug coverage while in the Coverage Gap? | The coverage gap ends on December 31, 2024. Starting in 2025, all Medicare plans will include a $2,000 cap on what you pay out-of-pocket for prescription drugs covered by your plan. If your out-of-pocket spending on covered drugs reaches $2,000 (including certain payments made on your behalf, like through the Extra Help program), you’ll automatically get “catastrophic coverage.” That means you won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year. |
| If my mom reaches the Coverage Gap in 2024, what is the percentage discount she will get on covered brand-name prescriptions when she is completely within the coverage Gap? She is not on Medicaid and she does not get extra help. | Same as above |