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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.

Market Power

The size of one firm relative to its competitors in a given market. Certain insurers or health systems have greater market power which enhances their…