Are a permanent resident in the service area of the plan
Stages and Cost Sharing
HOW DO STANDARD PART D PLANS WORK?
Annual Deductible: The amount you must pay each year for your prescriptions before your Medicare Part D plan begins to pay its share of your covered drugs.
You pay $415
Initial Coverage: Once you meet your annual deductible, your plan pays for most of your drug costs, and you pay a set amount (copay) or a percentage of the costs (coinsurance).
You pay 25%
Coverage Gap: Most Part D plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. The gap begins once you and your plan have paid $3,820 for covered drugs for the year.
You pay 37% for generic drugs and no more than 25% for covered brand-name drugs**
Catastrophic Coverage: Once you’ve spent $5,100 out of pocket in 2019, you’re out of the coverage gap, and receive “catastrophic coverage.” This means you’ll only pay a small copay or coinsurance for covered drugs the rest of the year
You pay $3.40 or 5%** for generic drugs and $8.50 or 5%** for other drugs