The Medicare Gap (also known as the Medigap) is a coverage gap. It is a standard guideline set by Medicare. It covers the point in Medicare Part D prescription drug coverage where the plan no longer pays for drugs after a certain amount has been paid out (although some will cover generics). This coverage gap is sometimes also referred to as “the donut hole.” It is not difficult to reach this point very quickly, as many Medicare recipients incur high prescription costs. Unfortunately they are left to pay their prescription costs out of pocket, which can create quite a financial burden for them. The recipient will continue to pay out of pocket until they have reached what is referred to as “catastrophic coverage,” an amount which can change from time to time.
Using generic prescriptions is the easiest way to avoid reaching the coverage gap. You will not reach the coverage gap as quickly or at all. Check with your doctor about the option of using generics over brand names.
Medigap plans cover the difference between the expenses paid for by Medicare and the amount charged by the recipient’s health care provider. There are ten different types of plans offered in most states. Some have a limited set of benefits beyond Medicare and others have a comprehensive set, and each plan varies in cost.
Your ultimate goal will be to choose the Medigap plan with the benefits that best suit your needs and find the insurance company that offers that plan at the lowest cost available to you. This may take some time and effort, but it is a worthwhile investment.