Medicare Part D

Medicare Part D

Medicare Part D is private insurance to help cover the cost of prescription medications. Part D plans provide coverage for both generic and brand name medications and can be added to Medicare Part A, B or Medicare Supplement Plans. It can also be included in a Medicare Advantage Plan. You can only be enrolled in one Part  D plan at a time.

The Steps of Part D Drug Coverage

There are four steps of drug coverage during the calendar year. Your drug plan will send you statements on these amounts as you fill your prescription drugs. 

Step 1 Annual Deductible

If your plan has a deductible, you will pay the full cost of the drug until you reach the deductible amount. For 2021 no plan may exceed a deductible of $445. Once this is reached you will pay the cost-share for the covered drug. 

Step 2 Initial Coverage

After you have met your deductible, you will pay your plan's copays or coinsurance for covered drugs. You are in this stage until your total yearly costs reach $4,130. The total yearly costs are the total drug costs paid by both you and your plan. 

Step 3 Coverage Gap

Also referred to as the Donut Hole, you will pay 25% of the plan's cost for covered Brand-Name and Generic Drugs until your costs total $6,550.

Step 4 Catastrophic Coverage

After your yearly costs reach $6,550 you will pay the greater of 5% of the cost or $3.70 for Generic and $9.20 for Brand-Name drugs.

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