Prescription Drug Coverage (Part D)

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? 

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.

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

Please feel free to contact me today to discuss prescription drug coverage!

623-879-2488

phil@gcgagent.com