During the coverage gap, how much do consumers typically pay for generic drugs?

During the coverage gap, also known as the "donut hole," consumers typically pay 25% for generic drugs. This percentage is designed to help balance the cost-sharing burden on beneficiaries, as they transition from the initial coverage period to the catastrophic coverage stage. While individuals may assume that generic drugs, which are generally less expensive than brand-name medications, would have a lower coinsurance percentage, the structure of the Medicare Part D plan standardizes the cost share at 25% during this particular phase.

Understanding the dynamics of the coverage gap is crucial for beneficiaries to anticipate their costs accurately. While the other options reflect various percentages, they do not align with the established regulations governing Medicare drug coverage during the gap, where 25% is the standard rate that consumers will face for generic drugs.