Plan Costs

In general, people are responsible for paying the following for a Medicare drug plan:

• Monthly premiums
• Annual deductible
• Copayments or coinsurance
• A small copayment for the rest of the calendar year after they reach a certain out-of-pocket amount

After people reach a drug plan’s standard level of coverage, they may have to pay costs for their prescriptions until reaching a catastrophic coverage level. Medicare calls this period the coverage gap.

Plans offer catastrophic coverage for people that have an unexpected illness or injury resulting in extremely high drug costs. This coverage pays almost all drug costs after the patient has paid a set amount of drug costs out-of-pocket during a calendar year.