What is the basic Medicare Part D coverage model?
The basic Part D plan is made up of four parts. Part 1 – An initial deductible of $275.00. Some plans waive the deductible, but these same plans may have a higher monthly premium. Part 2 – Beneficiaries are required to pay a co-payment or coinsurance for each prescription until the retail cost of the medications reaches $2,150. Some plans may lower the the limit to $2,000 or $1,850 which usually results in lower monthly premiums. Part 3- Once the beneficiary reaches the coverage limit defined above, they enter into a coverage gap or “donut hole”. At this point beneficiaries are responsible for 100% of their medciation costs. Some plans provide partial or complete coverage for this gap in the Medicare Part D coverage. Part 4 – Once a beneficiaries true out of pocket costs exceeds $4050 for prescription medications they enter into to the “catastrophic coverage” where the cost of medications is substantially reduced. The $4050 does not include the portion of prescription medications paid
