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

  • I certify that I have made no alterations, amendments or other changes to this Medicare Coverage Gap Discount Program Agreement.

  • If Tenant fails to bring the work in question up to the required standards within such 30 day period, Landlord may complete such work (but shall have no obligation to do so) and Tenant shall pay the entire cost thereof to Landlord within fifteen (15) calendar days after Tenant’s receipt of Landlord’s written demand therefor.

  • This provision is subject to: • the implementation of the updated plans; • the continuing maintenance of, as applicable, the individual or collective agreed resource commitments; and, • the individual or collective performance milestones being met and adequately addressing the Core Segment Coverage Gap during the Initial Marketing Period.

  • Inmarsat and such DPs shall, within 30 days of receipt of the updated plan, use all reasonable endeavours to agree the level of resources and performance milestones necessary to address the Core Segment Coverage Gap.

  • Valeant shall use Commercially Reasonable Efforts to appropriately list the Product bearing the Valeant NDC on its own Medicaid Rebate Program agreement, PHS 340B Program agreement, VA Master Agreement, FSS agreement, TriCare Rebate Program agreement, and Medicare Part D Coverage Gap Rebate Program agreement as soon as practicable after the Transfer Date.

  • For all other covered Non-Part D Drugs during the Coverage Gap Stage you continue to pay your copayment or coinsurance as stated in the Initial Coverage Stage.

  • Neither the Company nor its Subsidiaries is, in any material respect, resubmitting or planning to resubmit to the government any data reported under the Medicaid Rebate Statute, Medicare Part B Drug Pricing requirements, 340B Program requirements, Veterans Health Care Act of 1992, or the Medicare Part D Coverage Gap Discount Program, or refunding any monies owed due to a resubmission.

  • For clarity, the term “Rebate Contract” shall include all Medicare Part D prescription drug plans, but shall not include the Medicare Coverage Gap Discount Program.

  • If you have any questions about the availability of a discount 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).

  • The Medicare Coverage Gap Discount Program provides manufacturer discounts on Part D brand name drugs to Part D enrollees who have reached the coverage gap and are not already receiving “Extra Help.” A 50% discount on the negotiated price (excluding the dispensing fee and vaccine administration fee, if any) is available for those Part D brand name drugs from manufacturers that have agreed to pay the discount.


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 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