Medicare Part D - Closing the Coverage Gap


The Medicare Part D Coverage Gap (also known as the Donut Hole) is closing in 2020. One change that that has already taken affect early in 2019, is that plan members of a Part D or (a Medicare Advantage Plan that includes drug coverage) will only pay 25% coinsurance of Brand-name drugs while in the coverage gap. However, during the coverage gap, Generics will be only start to be reduced to 25% coinsurance for plan members starting in 2020.

The coverage gap closes by keeping the manufacturers 50% discount and increasing what Medicare drug plans cover. The coverage gap had been gradually shrinking for several years since the Affordable Care Act set a path to close it by 2020. However the gap really was never scheduled to close 100%. Once the coverage gap closes, you still doesn’t mean you will get your medications for free, plan members will still pay 25% out of their pockets while in the coverage gap.



Click on link for a related blog post of what is the coverage Gap (also known as the Donut Hole): Medicare Part D - The Doughnut Hole



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