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    Medicare Part D

    Medicare Part D (drug coverage) can be purchased by private insurance companies.  There are two main ways to get this coverage:

    1.  Separate, stand-alone prescription plan.  This is typically done when you have a Medicare Supplement plan.
    2.  Medicare Advantage - Most Medicare Advantage plans offer the Medicare Part D prescription coverage.  

    Medicare Part D Standard Benefit Plan (2021)

    Initial Deductible: $445

     

    The amount you pay before a plan covers your prescription drug costs.

     

    Initial Coverage Limit: $4,130

     

     

     

    During this stage, the plan pays its share of the cost
    and you pay your share. You are in this stage until
    your payments and the plan’s payments total $4,130
    for the year.

    Coverage Gap (“donut hole”)

     

     

     

    		When your drug costs and plan payment for the year
    reach $4,130 , you enter the Coverage Gap Stage
    (donut hole). You will pay 25% of the cost for
    formulary brand-name and generic drugs. You will
    stay in this stage until your out-of-pocket costs for
    the year reach $6,550 .

    Catastrophic Coverage

     

     

     

    		After your out-of-pocket costs for prescription drugs
    reach $6,550 , the plan will pay most of your drug
    costs for the rest of the year. You will pay either 5%
    of the cost of the drug, or a co-pay of $3.70 for
    generic drugs or $9.20 for all other drugs.