What percentage does a member pay for generic drugs while in the coverage gap?

During the coverage gap, commonly referred to as the "donut hole," Medicare beneficiaries are typically required to pay a specific percentage for their prescription drugs. For generic drugs, this percentage is set at 25%.

This means that, when in the coverage gap, members are responsible for 25% of the cost of their generic medications. The importance of this arrangement is that it allows beneficiaries to access their medications at a reduced cost during a period when they would otherwise face increased out-of-pocket expenses.

Understanding this percentage is critical for members as it affects their budgeting for healthcare costs throughout the year, particularly when they reach the coverage gap in their Medicare prescription drug plans. Thus, the correct answer reflects the standard cost-sharing requirement for generic drugs during this stage of coverage.