The Medicare & Medicaid Center

Knowing what does or does not count towards the Medicare Part D coverage gap is almost as hard as understanding what it is in the first place. It is important to you, however, to know what this gap is and what counts towards it to ensure you aren’t paying double for your prescription drugs. Here is a little guide towards what does count for the coverage gap:

• You get a discount on brand-name drugs in the coverage gap and this counts towards closing the coverage gap.
• You can also include what you pay while you are in the coverage gap to help you navigate your way out of the coverage gap.
• Every covered payment you make during the year goes towards closing the coverage gap as well. This means that your copayments, coinsurance and even your deductibles will help you to close this coverage gap.

You should note that you cannot count your monthly premiums towards your coverage gap as those are not considered. Although it is obvious that almost everything else you have to pay for will be a part of this coverage gap for you.