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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:
- Separate, stand-alone prescription plan. This is typically done when you have a Medicare Supplement plan.
- 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.