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 as your share of the cost for prescription drugs.
- Premium – The periodic payment to Medicare, an insurance company or 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. 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.
- 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 and benefits.
Some members may face additional costs or fees. For example, the Late Enrollment Penalty (LEP)
is an amount added to your Medicare Part D premium. You may owe a 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.
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.