How Do Prescription Drug Plans Work?
Here is important information you need to know about owning a prescription drug plan:
Annual Deductible — There is a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $480 in 2022. You will pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.
Initial Coverage — During initial coverage, you pay a copay for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copay amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2022, the initial coverage cap is $4,430. After you and the insurance company together have paid this amount, then you enter the coverage gap.
The Coverage Gap – During the coverage gap, you will still generally have significant discounts for generic medications. Typically, you will pay 25% for generic and name brand medications. Your gap spending will continue until you have paid $7050 out of your own pocket in 2022.
Catastrophic Coverage – If you should spend past the coverage gap, you will pay the greater of 5% coinsurance OR $3.95copay for generic, and, $9.85 copay for brand or nonpreferred drugs in your formulary for the rest of the year.
How would I enroll?
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