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Know Your Plan: Will the Coverage Gap affect me?

Will the Coverage Gap affect me?

How do I get in and out of the coverage gap?

Know your Gap Status: Track Your Spending

You may see little or no impact from the coverage gap if:

• You have very low drug costs each year.
• You have "extra help" (limited income subsidy) from Medicare or Social Security.
• You have Medicaid. (You may qualify for Medicaid part way through the year if your out-of-pocket spending on medicines or other healthcare significantly reduces the income you have left for living expenses.)
• You have coverage from a state program in addition to Medicare.
• You have an "enhanced" Medicare prescription drug plan or a Medicare Advantage Plan that provides extra coverage during the gap, possibly even eliminating it. You may switch to one of these plans during the next enrollment period (November 15 through December 31).