Many people take at least one prescription drug every day. That makes drug costs a top concern when choosing a Medicare Part D plan.
Medicare Part D costs usually include premiums, deductibles, and co-pays. The specific amounts paid vary depending on the plan you have, the drugs you take, where you get your drugs, how often you need them and if you have any financial help (such as from the Extra Help program).
Here are four Part D costs that you may want to know more about as you review your Medicare drug coverage and costs.
1. Split-Tier Deductibles
Most plans have a tiered formulary (drug list). Tiered formularies organize drugs into tier levels, and typically the higher the tier number, the more expensive the drug. Generally, tier 1 drugs are generic drugs.
Part D plans may have no deductible, a split-tier deductible, or one deductible that applies to all drug tiers. It’s important to review plan materials and understand the costs when selecting a plan. Part D plans in your area may vary quite a bit. You want to make sure to choose a plan that covers the drugs you take at a cost you’re comfortable with.
2. Medicare Part D Coverage Gap (“Donut Hole”) Costs
You may know about the Part D coverage gap (or the “donut hole”), but if you don’t, it’s important to understand that when you are in it, you may pay more for your medications.
Most people don’t enter the coverage gap because their drug costs aren’t high enough, but it’s still a good idea to understand how it works and what you could be financially responsible for.