How Do Prescription Drug Plans Work?

Here is important information you need to know about owning a prescription drug plan:

  • Annual Deductible — Most plans have a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $505 in 2023. You'll pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.

  • Initial Coverage — During initial coverage, you pay a copay for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copy amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2023, the initial coverage cap is $4,660. After you and the insurance company together have paid this amount, then you enter the coverage gap.

  • The Coverage Gap – During the coverage gap, you will still generally have significant discounts for generic medications. Typically, you will pay 25% for name brand medications and 37% for generics. Your gap spending will continue until you have paid $7,400 out of your own pocket in 2023.

  • Catastrophic Coverage – If you should spend past the coverage gap, your plan will begin to pay up to 95% of the costs of your formulary medications for the rest of the year.

How would I enroll?

Fill out the form and we will be in contact soon to talk.

See Which Plans Are In Your Area Today

By submitting your information, you acknowledge a licensed insurance agent may contact you by phone, email, or mail to discuss and quote Medicare Advantage Plans, Medicare Supplement Insurance, or Prescription Drug Plan

How Do Prescription Drug Plans Work?

Here is important information you need to know about owning a prescription drug plan:

  • Annual Deductible — Most plans have a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $505 in 2023. You'll pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.

  • Initial Coverage — During initial coverage, you pay a copay for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copy amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2023, the initial coverage cap is $4,660. After you and the insurance company together have paid this amount, then you enter the coverage gap.

  • The Coverage Gap – During the coverage gap, you will still generally have significant discounts for generic medications. Typically, you will pay 25% for name brand medications and 37% for generics. Your gap spending will continue until you have paid $7,400 out of your own pocket in 2023.

  • Catastrophic Coverage – If you should spend past the coverage gap, your plan will begin to pay up to 95% of the costs of your formulary medications for the rest of the year.

How would I enroll?

Fill out the form and we will be in contact soon or press the "Click to Call" button above to call us today!

See Which Plans Are In

Your Area Today

By submitting your information, you acknowledge a licensed insurance agent may contact you by phone, email, or mail to discuss and quote Medicare Advantage Plans, Medicare Supplement Insurance, or Prescription Drug Plan

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We do not offer every plan available in your area. We represent nine organizations that offer 134 products. Any information we provide is limited to

those plans we do offer in your area. Please contact 1-800-MEDICARE or your local State Health Insurance Assistance Program (SHIP) to get information

on all of your options.