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How many 2013 Medicare Part D prescription drug plans offer Donut Hole Coverage?

Archive: The Donut Hole or Coverage Gap · published Jun 8, 2013

Gap Coverage Types and Minimum Premium for 2013 stand-alone Medicare Part D Prescription Drug Plans

2013 Gap Coverage Details 2012 Gap Coverage Details
Gap
Coverage
Type		 Nbr of Plans Minimum Premium Gap
Coverage
Type		 Nbr. of Plans Minimum
Premium
No Gap Coverage 698 $15.00 No Gap Coverage 771 $15.10
Some Generics 69 $47.90 Some Generics 102 $54.50
Many Generics 66 $34.00 Many Generics 72 $55.60
Few Generics 32 $65.80 Few Generics 16 $61.00
All Generics 6 $88.90 All Generics 7 $66.60
Some Generics and Some Brands 93 $79.30 Some Generics and Some Brands 34 $79.30
Some Generics and Few Brands 1 $83.90
Many Generics and Some Brands 77 $86.20 Many Generics and Some Brands 39 $101.20
Many Generics and Few Brands 3 $88.80


For an example, click the "Gap Coverage Type" above to see Medicare Part D plan details for the state of California or choose your state from the California summary page.

Gap coverage descriptions apply to only formulary drugs purchased at Network pharmacies.

The Healthcare Reform provides that for Plan Year 2013, ALL formulary generics will have at least a 21% discount and ALL brand drugs will have at least a 52.5% discount in the coverage gap.

The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. The percentage of "Generic" and "Brand" drugs covered in the gap are each separately calculated and the following descriptions are used:
  • "All": 100% of formulary drugs of this type (generic or brand as noted) are covered through the gap. Ex: "All Generics". A label of "All Formulary Drugs" is applied for plans that cover 100% of "generic" and 100% of "brand" products (either by covering all formulary drug products in the gap or by having no initial coverage limit),
  • "Many": >=65% to <100% of formulary drugs of this type (generic or brand as noted) are covered through the gap. Ex: "Many Generics",
  • "Some": >=10% to <65 % of formulary drugs of this type (generic or brand as noted) are covered through the gap. Ex: "Some Generics",
  • "Few": >0% to <10% of formulary drugs of this type (generic or brand as noted) are covered through the gap (and must also be >15 products covered through the gap),
  • "No Gap Coverage": 0% of drugs are covered through the gap (or <=15 products covered through the gap).