The Gap

By now we all know that our major goal is to prevent our accumulating " Total Drug Costs " from reaching " The Gap " - or keeping these costs from penetrating too deeply into " The Medicare Part D Gap " - also known as " The Medicare Part D Donut Hole ".

When we fill a prescription at the pharmacy we are asked to pay the Co-pay amount that is required by the terms of our Insurance Plan. 

For a generic drug this amount could typically range from  $0 to $10. Our Insurance Plan has already negotiated a price that the pharmacy will receive for filling this prescription.

This negotiated price is lower than someone would pay to fill the prescription if they had no drug coverage. 

It is also the dollar amount that accumulates toward our  " Total Drug Costs " each time we fill a prescription. 

After our "Total Drug Costs" exceed an amount specified by Medicare each year we are in "The Medicare Part D Gap". 

( This amount is  $2960.00 for the calendar year 2015.) 

" Total Drug Cost " =  the amount paid by our Insurance Plan to the pharmacy + ANY CO-PAY PAID BY US. 


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