After you and the insurance company together have spent a certain amount on prescriptions (it's usually around $2,510 and it's called your initial coverage limit), PDP coverage changes. You enter the gap. When you're in the gap you pay for all of your prescriptions yourself until you've spent $4,050.

After you've spent $4,050 of your own money on prescriptions (that includes all your co-pays and co-insurance before the gap, but does not includes your premium), coverage changes again—for the better. Catastrophic coverage begins and your PDP provider pays for about 95% of your remaining drug costs for that calendar year.

The reasons behind the gap.
When the government created PDPs, they wanted to provide some help to all seniors and a safety net for those with really high drug costs. Having a coverage gap was a way to provide some coverage for everyone, and also take care of the folks who are really struggling—and make it all affordable.

WellCare's inexpensive generic drugs help you avoid the gap.
At WellCare, we work hard to provide you with money-saving options that make the most of your coverage by offering low co-pays on generic drugs. Not only does this help you get themost out of your coverage (because WellCare is paying for virtually all your drug costs), it also keeps costs low in general, so you won't enter the gap as fast—if at all.

	$4,050	Catastrophic Coverage	Catastrophic Coverage begins when Dan has spent $4,050 on drugs. For the rest of the year, WellCare pays 95% of Dan's drug costs; Dan pays 5%.
	$2,510	The Coverage Gap	The Coverage Gap starts when Dan and WellCare have spent $2,510 on drugs. Now, Dan pays for 100% of his prescriptions (at WellCare's discounted price).
	$0	Regular Coverage	Regular Coverage starts right away, because our plan has no deductible. WellCare pays for most drugs; Dan pays the co-pay for the prescriptions he receives (remember, there's no co-pay for generic drugs).

WellCare helps you keep track of the gap.
At WellCare, we give you a monthly statement that tracks your spending and ours—so you always know how close you are to the coverage gap. That way, there are no surprises and you can budget accordingly.

On a limited income? The gap works differently for you.
If you're on a limited income there is no coverage gap, because you will always have some coverage. Here's how it works: after you and WellCare together have spent a certain amount on prescriptions (usually $2,510), coverage changes and most people will have a small co-payment for generic drugs until the total expense between you and the company reaches $4,050, at which time the co-pay returns to $0.