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
Most Medicare Part D plans charge a monthly premium. Premiums vary from plan to plan.
People with incomes over a limit set by Medicare must pay an extra amount in addition to their Part D plan premium. This is called a Part D income-related monthly adjustment. The extra amount paid varies depending on the tax-reported income, and are paid to the federal government.
See the table below for how much extra you could pay each month in 2021.
You may have many Medicare Part D plans to choose from. You may also choose a Medicare Advantage (Part C) plan that includes drug coverage. Part D costs is just one consideration when choosing a plan – but an important one. Look carefully at your options and costs.