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Medicare Drug Coverage Gap or “Donut Hole”

A gap in coverage where the beneficiary pays 100% of drug costs up to a limit, created by Medicare Part D legislation. Affordable Care Act addresses this by offering rebate checks for participants who reach their coverage gap and by requiring pharmaceutical companies to offer discounts to consumers.

Mandatory Benefits

Specific benefits that are required to be covered by health insuring agencies plans. The number and type of benefits vary across states.