The Donut Hole in Webb City, MO is a Medicare Part D prescription drug benefit program that has been in effect since January 1, 2006. It is known for its controversial coverage gap, where enrollees go from making co-payments to paying 100% of the cost of their prescription drugs. The program provides coverage up to an initial limit and then requires beneficiaries to pay out-of-pocket until reaching a catastrophic coverage threshold.
With the aim of closing the coverage gap, The Donut Hole offers a defined standard benefit that includes a deductible and an initial coverage limit. Once beneficiaries surpass the coverage limit, they enter the catastrophic coverage phase, where they pay a reduced amount for generics or name brand medications. The program has garnered attention from lawmakers and seniors alike, as it can significantly impact the cost of prescription drugs for Medicare beneficiaries.
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