Medicare Part D is coverage for prescription drugs. You don’t automatically get this coverage when you become eligible for Medicare, yet many Americans rely on prescription drugs to maintain their health and well-being. It’s important to consider whether you need a plan with prescription drug coverage.
Medicare Part D covers brand-name and generic prescription drugs. You generally pay less – or nothing at all – for generic drugs.
Medicare Part D Prescription Drug Coverage includes four cost-sharing stages. The amount you pay to fill your prescription drugs depends on the payment stage you are in.
The amount you pay before a plan covers your prescription drug costs.
During this stage, the plan pays its share of the cost and you pay your share. You are in this stage until your payments and the plan’s payments total $4,130 for the year.
When your drug costs and plan payments for the year reach $4,130, you enter the Coverage Gap Stage, commonly known as the Donut Hole. You will pay 25% of the cost for formulary generic and brand-name drugs. You will stay in this stage until your out-of-pocket costs for the year reach $6,550.
After your out-of-pocket costs for prescription drugs reach $6,550, the plan will pay most of your drug costs for the rest of the year. You will pay either 5% of the cost of the drug, or a co-pay of $3.70 for generic drugs or $9.20 for all other drugs.
With MT&M we analize your prescriptions and match up with the best options for you to choose from. You can change your option during the open enrollment period begining in October and ending in December each year.
Your prescriptions will fall into different tiers based on the drug and whether or not it is generic. We will advise the best plan to work with your budget as well as search the pharmacies in your area.
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