Health Care & Medication
Medicare Prescription Drug Coverage
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Medicare has a program that helps pay for your prescription medicine. It is called Medicare Prescription Drug Coverage (also called Medicare Part D). This program pays for some, but not all, of your prescription drug costs. Here is a list of some costs that you will still need to pay:

  • Monthly premium: The amount of the premium you pay each month will depend on where you live, what plan you join, and your income. Visit Medicare.gov for more information about how your premium can go up based on your income.
  • Annual deductible: The plan deductible will be no more than $445 per year.
  • Coinsurance or copays: This decides the amount you pay for your prescription medicine after paying your monthly premium and the annual deductible. It is how you share the cost of the prescription medicine with your plan. With coinsurance, you pay a percentage of the cost of the medicine. With a copay, you pay a fixed dollar amount. 
  • Coverage gap or “donut hole”: Once the cost of your medicine reaches $4,130, you get a discount on your prescription drug costs. With the discount, you pay 35% of the cost of brand-name drugs and 45% of the cost of generic drugs. You also pay a small fee (called a dispensing fee) in addition to the discounted price you pay.
  • Catastrophic coverage: If your total drug costs are higher than $9,313 (that is, you have paid a total of $6,550 out of your own pocket), then Medicare will pay 95% of all your prescription drug costs.

 

Frequently Asked Questions

See What Key Benefits Programs You May Qualify For

BenefitsCheckUp can help you assess whether you can get help from programs before you apply. Answer questions anonymously to find out if you may be eligible for key benefits programs, including the Supplemental Nutrition Assistance Program (SNAP), Medicare Savings Programs, Medicaid, Medicare Part D Low Income Subsidy (LIS) - Extra Help, among others. 

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