How Do Prescription Drug Plans Work?
Here is essential information you need to know about owning a prescription drug plan:
Annual Deductible: There is a deductible you must pay for a Part D plan. Your deductible may be different or waived entirely, but the max amount you could be charged was $415 in 2019. You will 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. Generic drugs typically separate it, preferred name brands, even more, specialized medications, etc. In 2019, the initial coverage cap was $3,820. 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 paid $5100 out of your pocket in 2019.
Catastrophic Coverage: If you should spend past the coverage gap, your plan will begin to pay 95% of the costs of your formulary medications for the rest of the year.
How would I enroll?
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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