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In the coverage gap, member pays up to what percent of most brand named drugs?

User Foster
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Final answer:

In the coverage gap known as the 'donut hole', Medicare members pay up to 25% for brand-name drugs after recent changes to the prescription drug benefit structure.

Step-by-step explanation:

In the coverage gap of Medicare's prescription drug benefit, commonly known as the 'donut hole', members are required to pay a certain percentage of the cost for most brand-name drugs. Prior to recent changes, beneficiaries would pay 100% of prescription costs in the gap, but the Affordable Care Act included provisions to reduce this amount over time.

By 2020, the coverage gap was essentially closed, with members paying up to 25% for brand-name and generic drugs until they reach the catastrophic coverage threshold. This structure aims to lessen the financial burden on Medicare recipients, especially the elderly and disabled, who may need multiple prescription medications.

User Carpy
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