Medicare Part D Costs

The cost of a Medicare Part D plan is influenced by several different factors. These include:

  • Deductible – An amount you are required to pay before a plan begins to share the cost of prescriptions.
  • Premium – The monthly payment to Medicare, an insurance company or a health care plan for health or prescription drug coverage.
  • Copayment – An amount you may be required to pay as your share of the cost for a prescription drug after you pay any deductibles. A copay is usually a set dollar amount: for example, a $10 copay.
  • Coinsurance – An amount you may be required to pay as your share of the cost for prescription drugs after you pay any deductibles. Coinsurance is a percentage of the cost: (for example 20%).
  • Coverage Gap (Donut Hole) – The third stage of Medicare Part D prescription drug coverage following the Initial Coverage Stage, which is a temporary limit on what your drug plan will pay for prescription drug costs.
  • Generic Drug Cost – The amount you pay for your prescription if you opt for the generic rather than the brand name version of a drug; this is often less expensive than the cost of the brand name version.

The factors above are different for each plan. But before you compare the costs of our plans, consider your location. Plan costs and benefits vary by area, so make sure you type in your zip code to see the correct plan costs benefits.

Some members may face additional costs or fees. For example, the Part D Late Enrollment Penalty (LEP) is an amount added to your Medicare Part D premium. You will owe a Part D late enrollment penalty if, at any time after your Initial Enrollment Period is over, there's a period of 63 or more days in a row when you don't have Part D or other creditable prescription drug coverage (as good as Medicare’s).

Financial assistance is also available for eligible members. See if you qualify for Extra Help, a Social Security Administration program that helps people with limited incomes pay for their Medicare Part D costs.