The first stage occurs at the beginning of your prescription drug coverage. This is the period when you pay for your prescription drugs in full until you meet your yearly deductible amount. After the deductible is met, you move into the Initial Coverage stage.
Some plans do not have a yearly deductible. Under these plans, you would begin in the Before Gap or Initial Coverage stage.
Often called the 'Initial Coverage Phase', you will pay the plan's copays or coinsurance until a total drug cost of $4,130 in 2021 is reached.
Often called the 'Donut Hole Phase', you will pay the full cost of the covered drug until your total out of pocket cost reaches $6,550 in 2021.
Often called the 'Catastrophic Phase’, you will likely have lower cost sharing through the end of the calendar year once you have reached $6,550 in 2021 in out of pocket drug costs. See Evidence of Coverage for a complete description of plan benefits.