AKA prescription drug coverage, can be purchased with a supplement or as a stand alone plan with original Medicare. Part D plans are managed by Medicare and run by Private insurance companies.
Costs for prescription drug coverage vary by monthly premiums and a formula based system with preferred and standard pharmacies to calculate drug costs?
Part D drug plans and costs are rated by tiers set by CMS
Tier 1: Preferred generic drugs
Tier 2: Generic drugs
Tier 3: Preferred brand drugs and select insulin drugs
Tier 4: Non-preferred drugs
Tier 5: Specialty drugs
1. Deductible: If you have a deductible, you pay 100% of your drug cost until you meet your deductible.
2. Initial coverage: You will pay a copay or a percentage of the cost, and your plan pays the rest for your covered drugs.
3. Coverage Gap: aka the donut hole: After you enter the coverage gap, you pay a percentage of the plan’s cost for covered brand name drugs and/or covered generic drugs until your costs total $7050.
4. Catastrophic Coverage: after your yearly out of pocket drug costs reach $7050, the plan pays most, or in some cases all, of your covered drug costs.
Have Questions?
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