What is usually required for Medicare Part D beneficiaries before coverage resumes during the coverage gap?

Medicare Part D beneficiaries typically experience a coverage gap, often referred to as the "donut hole," where they must pay a higher percentage of their drug costs. Before their coverage resumes, beneficiaries are generally required to reach their deductible amount. This deductible is a predetermined amount that enrollees must pay out-of-pocket for their medications before their Medicare Part D plan begins to cover costs again. Once beneficiaries have spent enough to meet this deductible during the coverage gap, their insurance will once again contribute towards their drug costs.

The other choices do not align with the requirements for resuming coverage. For instance, an annual income assessment is more relevant to determining eligibility for certain programs or subsidies but does not directly affect the resumption of coverage in the context of the coverage gap. Filing a claim with a provider is part of the claims process, but it is not specifically linked to the conditions under which coverage resumes in the coverage gap. Similarly, obtaining a referral is not a requirement for Medicare Part D, as it primarily applies to Medicare Part B and is associated with accessing certain types of healthcare services rather than prescription drug coverage. Therefore, reaching the deductible is the correct requirement before coverage resumes during this period.