Archive: Does everyone receive a discount in the Coverage Gap?

Archive: Closing the Coverage Gap · updated Jul 7, 2019

No. Only Medicare beneficiaries enrolled in a Medicare Part D prescription drug plan (PDP) or a Medicare Advantage plan that offers a prescription benefit (MA-PD)

and who are not enrolled in a qualified retiree prescription drug plan
and are not entitled to an income-related subsidy (LIS)
and who have reached or exceeded the Initial Coverage Limit during the year
and have not yet entered the Catastrophic Coverage phase of their prescription drug plan coverage

...will receive the discount.

Please note that enrollees in employer group health and waiver plans may also eligible for participation in the Discount Program.