Coverage Gap definition

Coverage Gap means the stage of the benefit between the initial coverage limit and the catastrophic coverage threshold, as described in the Medicare Part D prescription drug program administered by the United States federal government.
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Coverage Gap means the phase in prescription drug coverage that occurs between the initial coverage limit (as defined in 1860D-2(b)(3) of the Act) and the out-of-pocket threshold (as defined in section 1860D-2(b)(4)(B) of the Act). For purposes of applying the initial coverage limit, Part D sponsors shall apply their plan specific initial coverage limit under basic alternative, actuarially equivalent, or enhanced alternative Part D benefit designs.
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Coverage Gap means the out-of-pocket expenses for medications between the point where an eligible person exceeds the Medicare Part D coverage limit under § 1860D-2(b)(3) (42 U.S.C. § 1395w-114a) of the Patient Protection and Affordable Care Act and below the catastrophic amount specified in § 1860D2(b)(4)(B) of the Patient Protection and Affordable Care Act for the year.
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Examples of Coverage Gap in a sentence

  • Remember you are responsible for all of the costs associated with vaccines (including their administration) during the Deductible and Coverage Gap Stage of your benefit.Situation 1: You buy the Part D vaccine at the pharmacy and you get your vaccine at the network pharmacy.

  • Remember you are responsible for all of the costs associated with vaccines (including their administration) during the Coverage Gap Stage of your benefit.Situation 1: You buy the Part D vaccine at the pharmacy and you get your vaccine at the network pharmacy.

  • Medicare Coverage Gap Discount ProgramThe Medicare Coverage Gap Discount Program provides manufacturer discounts on brand name drugs to Part D members who have reached the coverage gap and are not receiving “Extra Help.” For brand name drugs, the 70% discount provided by manufacturers excludes any dispensing fee for costs in the gap.

  • Also, the dispensing fee is included as part of the cost of the drug.The Medicare Coverage Gap Discount Program is available nationwide.

  • The Medicare Coverage Gap Discount Program is available nationwide.

  • If you get “Extra Help,” the Medicare Coverage Gap Discount Program does not apply to you.

  • When you are in the Coverage Gap Stage, the Medicare Coverage Gap Discount Program provides manufacturer discounts on brand name drugs.

  • Please go to Chapter 6, Section 6 for more information about your coverage during the Coverage Gap Stage.

  • If you have any questions about the availability of discounts for the drugs you are taking or about the Medicare Coverage Gap Discount Program in general, please contact Member Services (phone numbers are printed on the back cover of this booklet).

  • Most members do not reach the Coverage Gap Stage or the Catastrophic Coverage Stage.


More Definitions of Coverage Gap

Coverage Gap means the gap phase in prescription drug coverage that occurs between the initial coverage limit (as defined in 1860D-2(b)(3)) and the out-of-pocket threshold (as defined in section 1860D-2(b)(4)(B)). For purposes of applying the initial coverage limit, Part D sponsors shall apply their plan specific initial coverage limit under basic alternative or actuarially equivalent Part D benefit designs.
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Coverage Gap means the need for additional capacity because of inadequate present capacity or service, dead spots, and inability to place a call.
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Coverage Gap has the meaning set forth in 42 CFR §423.100.
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Coverage Gap means the out-of-pocket expenses for medications between the point where an eligible person exceeds the initial coverage limit ($2,840 in retail drug costs for covered drugs in 2011) under section 1860D-2(b)(3) (42 U.S.C. 1395w-114a) of the Patient Protection and Affordable Care Act and below the annual out of pocket threshold specified in section 1860D2(b)(4)(B) for the year ($4,550 in 2011). These annual out-of-pocket expenses include annual deductibles, co-payments, and coinsurance amounts.
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Coverage Gap means a geographic area where a telecommunication carrier has a significant gap in service coverage.
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Related to Coverage Gap

  • Coverage Area means the area described in the Website for which Nearmap has available Products, which may cover part or all of that area and which may cover part (but not all) of the area covered by the Survey.

  • Individual health insurance coverage means health insurance coverage offered to individuals in the

  • Coverage Term All insurance required herein shall be maintained in full force and effect until Work required to be performed under the terms of the Contract are satisfactorily completed and formally accepted; failure to do so may constitute a material breach of this Contract, at the sole discretion of the TOWN. In the event any insurance policy(ies) required by this contract is(are) written on a “claims made” basis, coverage shall extend for two(2) years past completion and acceptance of the CONTRACTOR’s work or services, as evidenced by annual Certificates of Insurance.

  • Coverage means the types of persons to be eligible as the beneficiaries of the Scheme to health services provided under the Scheme, subject to the terms, conditions and limitations.

  • Coverage Period means the time period specified on the Declarations Page beginning on the effective date and ending on the expiration date. All dates are as of 12:01 AM in the time zone of the Policyholder.

  • Health insurance coverage means benefits consisting of medical care (provided directly, through

  • Group health insurance coverage means in connection with a group health plan, health insurance

  • Insurance Coverage Contractor shall, at Contractor’s sole expense, procure, maintain and keep in force for the duration of this Contract the following insurance conforming to the minimum requirements specified below. Unless specified herein or otherwise agreed to by the City, the required insurance shall be in effect prior to the commencement of work by Contractor and shall continue in force as appropriate until the latter of:

  • insurance period means a contribution period or an equivalent period;

  • Coverage territory means the United States of America (including its territories and possessions), Puerto Rico and Canada.

  • Lot coverage means the portion or percentage of the area of a lot upon which buildings are erected.

  • long-term insurance business means the business of providing or undertaking to provide policy benefits under long-term policies, but does not include -

  • group insurance means insurance, other than creditor’s group insurance and family insurance, whereby the lives of a number of persons are insured severally under a single contract between an insurer and an employer or other person; (“assurance collective”)

  • Asset Coverage means “asset coverage” of a class of senior security which is a stock, as defined for purposes of Section 18(h) of the 1940 Act as in effect on the date hereof, determined on the basis of values calculated as of a time within 48 hours (only including Business Days) next preceding the time of such determination.

  • Co-insurance means the percentage of the usual, reasonable, customary, and fair market value expense that a covered person must pay.

  • Health care coverage means any plan providing hospital, medical or surgical care coverage for

  • Creditable coverage means, with respect to an individual, coverage of the individual provided under any of the following:

  • Insurance Cover means the aggregate of the maximum sums insured under the insurance taken out by the Contractor pursuant to Article 20, and includes all insurances required to be taken out by the Contractor under Clauses 20.1 and 20.9 but not actually taken, and when used in the context of any act or event, it shall mean the aggregate of the maximum sums insured and payable or deemed to be insured and payable in relation to such act or event;

  • Health insurance carrier or "carrier" means any entity subject to the insurance

  • Blanket insurance policy means a group policy covering a defined class of

  • Continuous period of creditable coverage means the period during which an individual was covered by creditable coverage, if during the period of the coverage the individual had no breaks in coverage greater than sixty-three (63) days.

  • Period of Coverage means the Plan Year, with the following exceptions: (a) for Employees who first become eligible to participate, it shall mean the portion of the Plan Year following the date on which participation commences, as described in Section 3.1; and (b) for Employees who terminate participation, it shall mean the portion of the Plan Year prior to the date on which participation terminates, as described in Section 3.2.

  • Insurance means (i) all insurance policies covering any or all of the Collateral (regardless of whether the Collateral Agent is the loss payee thereof) and (ii) any key man life insurance policies.

  • life insurance business means the business of providing or undertaking to provide policy benefits under life policies;

  • Period of Insurance means the period commencing from the retroactive date and terminating on the expiry date as shown in the Policy Schedule.

  • Liability Insurance means compulsory professional liability errors and omissions insurance required by a governing body;