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Resources for Medicare Beneficiaries: Navigating the Coverage Gap | How the Gap May Affect You

Resources for Medicare Beneficiaries: Navigating the Coverage Gap | How the Gap May Affect You

This six-page brochure helps Medicare Part D recipients and caregivers better understand the Medicare coverage gap, often referred to as the “donut hole.” During the “donut hole,” Medicare temporarily stops paying for prescriptions and recipients must pay the entire costs of the medicines by themselves. This brochure explains:

  • Who may be affected by the coverage gap;
  • How the coverage gap works; and
  • How to track covered drug expenses (a sample expense log is provided).

Spanish version of this brochure also is available (2009).

Newsletter Volume

E.V.I.dently January 2016

MessageThe Importance of Evidence, Value, Access and Innovation in 2016In his annual health care outlook, NPC President Dan Leonard explains why...
Blog Post

#TBT: Value-Based Insurance Design & New Medicare Advantage Model

As part of our Throwback Thursday blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous research...
Press Release

New Study Examines Risk-Sharing Agreements Between Pharmaceutical Manufacturers and Payers

(Washington, DC, September 16, 2015)—A newly released study has found that risk-sharing agreements (RSAs) between pharmaceutical companies and health...
Blog Post

CER Tweets of the Week: Study on Six Potential EBM “Biases”; VBID "Gets Its Medicare Close-up" (August 31-September 4)

This week on Twitter, comparative effectiveness research (CER) stakeholders shared a study examining six potential biases against patients and carers...
Press Release

New Study Examines Risk-Sharing Agreements Between Pharmaceutical Manufacturers and Payers

(Washington, DC, September 16, 2015)—A newly released study has found that risk-sharing agreements (RSAs) between pharmaceutical companies and health...
Press Release

NPC Comments on CMS’ Announcement to Allow Broader Access to Publicly Funded Databases

(Washington, DC, June 2, 2015)—The National Pharmaceutical Council (NPC) today commented on the Centers for Medicare and Medicaid Services’ (CMS)...
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Fellowship in Policy Impact of Comparative Effectiveness Research Awarded By National Pharmaceutical Council and George Washington University

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Study Quantifies Impact of Pharmaceuticals on Enhanced Productivity

(WASHINGTON, DC, August 1, 2012)–The costs to employers of chronic health conditions on employee productivity are well documented, but few studies...
Commentary and Testimony Page

NPC Comments on CMS' Proposed Changes to Protected Classes

March 7, 2014Marilyn B. TavennerAdministratorCenters for Medicare & Medicaid ServicesU.S. Department of Health and Human Services200 Independence...
Commentary and Testimony Page

What Will 2011 Hold for CER and PCORI?

When future historians consider health care, they may well look back on 2010 as a watershed year in America. The issues and events that occurred last...
Commentary and Testimony Page

NPC Reflects on Changes in 2010

It’s been a year of great change not only for the biopharmaceutical industry, but for the National Pharmaceutical Council as well. With these changes...
Commentary and Testimony Page

A Look at Value-Based Insurance Design

This month, NPC released a new report, “Value-Based Insurance Design Landscape Digest,” focusing on an important approach being used by leading edge...
YouTube Videos

Consumer-Directed Health Plans

A unique survey of large employers sheds light on the strategies and best practices that they follow when designing and implementing consumer-...
YouTube Videos

Engaging Consumers in Today's Changing Health Care Payment and Delivery Environment

The current health care delivery system is evolving from a fee-for-service system to one that is performance-based. How does this shift impact...
YouTube Videos

Can We Bring Clarity, Consistency and Transparency to Payer Coverage Decisions?

There is a bit of a "black box" around the formulary decision-making process. As a result, decisions about treatment access are often unpredictable...
YouTube Videos

How Do Payers Consider Individual Treatment Effects?

Dr. Robert Epstein, former chief medical officer and senior vice president of medical affairs at Medco Health, explains that heterogeneity, or...
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#TBT: Value-Based Insurance Design & New Medicare Advantage Model

As part of our Throwback Thursday blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous research...
Blog Post

CER Tweets of the Week: Study on Six Potential EBM “Biases”; VBID "Gets Its Medicare Close-up" (August 31-September 4)

This week on Twitter, comparative effectiveness research (CER) stakeholders shared a study examining six potential biases against patients and carers...
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Consumer-Directed Health Plans & Employees' Health and Productivity

More employers are offering consumer-directed health plans (CDHPs), which are high-deductible plans offered in combination with an account that...
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High-Deductible Health Plans, Pharmacy Benefits & "Better Practices"

It is the time of year when many employers, insurance companies and health exchanges are finalizing decisions about coverage and benefit options for...

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On behalf of the National Pharmaceutical Council, Th

The Myth of Average: Why Individual Patient Differences Matter

Within today’s health care environment, so much of t

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