Medicare RX Plans
Medicare RX Plans Information
Medicare RX Quote Form
Basic Medicare Part D coverage works like this:
Part D Monthly Premiums:
You pay premiums all year
Initial Deductible:
The allowed maximum annual deductible under Part D plans is $545
Initial Coverage Limit:
$5,030. Limit is calculated by the total amount of the actual cost of your prescriptions.
Example: Your Prescription costs $100 yet your copay is $10. The cost of the drug, $100, is applied to your coverage limit.
Coverage Gap aka The Donut Hole(DH):
Begins once the actual cost of your drugs reaches your Plan's Initial Coverage Limit of $5,030 (the combined amount plus
your deductible).
Ends when you spend a total of $8,000 out of pocket, which is referred to as your True Out of Pocket Threshold (TrOOP).
2024 Coverage Gap/DH Expenses:
Copays you incur during the Coverage Gap/DH, count towards satisfying your TrOOP
Brand-name Prescriptions: You pay 25% co-pay on brand-name drugs purchased while in the Coverage Gap/DH
You are receiving a 75% discount on the total cost of the brand-name drug.
Catastrophic Coverage :
All Other Prescriptions: You pay $0.00
Note: Even if you are not taking any Rx’s, you should enroll in a Part D Rx plan. Failing to do so will result in accruing a 1%
per month penalty for every month you could have been in a standalone PDP and was not. This penalty is “for life”—
once you do enroll in a PDP, the penalty will be added onto the new RX plan’s monthly premium.
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