Ms. Smith pays the
first $310 of her
drug costs before
her plan starts to
pay its share. |
Ms. Smith pays a
copayment, and her
plan pays its share
for each covered
drug until their
combined amount
(plus the
deductible) reaches
$2,840. |
Once Ms. Smith
and her plan have
spent $2,840 for
covered drugs, she
is in the coverage
gap. In 2011, she
gets a 50% discount
on covered brandname
prescription
drugs that counts as
out-of-pocket
spending, and helps
her get out of the
coverage gap.
|
Once Ms. Smith
has spent $4,550
out-of-pocket for
the year, her
coverage gap ends.
Now she only pays
a small copayment
for each drug until
the end of the year. |