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.

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

  • Payments made by Medicare’s “Extra Help” Program are also included.• Some payments made by the Medicare Coverage Gap Discount Program are included.

  • If you do reach this amount, you will leave the Initial Coverage Stage and move on to the Coverage Gap Stage.

  • Remember you are responsible for all of the costs associated with vaccines (including their administration) during the Coverage Gap Stage of your benefit.

  • 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.

  • 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 vaccine at the pharmacy and you get your Part D vaccine at the network pharmacy.

  • Changes to the Coverage Gap and Catastrophic Coverage StagesThe Coverage Gap Stage and the Catastrophic Coverage Stage are two other drug coverage stages for people with high drug costs.

  • When you buy the drug for a price that is lower than our priceSometimes when you are in the Deductible Stage and Coverage Gap Stage you can buy your drug at a network pharmacy for a price that is lower than our price.● For example, a pharmacy might offer a special price on the drug.


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 a geographic area where a telecommunication carrier has a significant gap in service coverage.
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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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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 means the period of Coverage for which the Life Insured is covered under the Policy, commencing from the Effective Date of Coverage to the Termination Date of Coverage and shall be of a term as mentioned in the Policy Schedule attached herewith & as mentioned in the Certificate of Insurance.

  • Coverage or “Covering”) shall mean that the developing, making, using, offering for sale, promoting, selling or importing of a given compound, formulation or product would infringe a Valid Claim of an issued patent in the absence of a license under such Valid Claim. The determination of whether a compound, formulation or product is Covered by a particular Valid Claim shall be made on a country-by-country basis.

  • 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;

  • The Coverage Period means the Days of the Week and the hours of those Days during which maintenance, operational, and/ or technical support services (if any) must be available.

  • 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 blanket insurance and franchise insurance and any other forms of group insurance.

  • Asset Coverage means asset coverage, as determined in accordance with Section 18(h) of the 1940 Act, of at least 200% with respect to all outstanding senior securities of the Trust which are stock, including all Outstanding Series B Preferred Shares (or such other asset coverage as may in the future be specified in or under the 1940 Act as the minimum asset coverage for senior securities which are stock of a closed-end investment company as a condition of declaring dividends on its common stock), determined on the basis of values calculated as of a time within 48 hours (not including Saturdays, Sundays or holidays) 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.