gross covered prescription drug costs

(3) Gross covered prescription drug costs Subject to paragraph (2)(B), for purposes of this section, the term “gross covered prescription drug costs” means, with respect to a part D eligible individual enrolled in a prescription drug plan or MA–PD plan during a coverage year, the costs incurred under the plan, not including administrative costs, but including costs directly related to the dispensing of covered part D drugs during the year and costs relating to the deductible. Such costs shall be determined whether they are paid by the individual or under the plan (or, with respect to 2025 and subsequent years, in the case of an applicable drug, as defined in section 1395w–114c(g)(2) of this title , by a manufacturer), regardless of whether the coverage under the plan exceeds basic prescription drug coverage.

Source

42 USC § 1395w-115(b)(3)


Scoping language

for purposes of this section
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