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.
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
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.
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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