Tuesday, July 10, 2018

Medicare Drug Plan Deductible - How Does It Work?

How do Medicare Part D prescription drug plans work? Why do some have a deductible? Am I required to pay the deductible up front before I can have a copay? Does the copay apply to all drugs? Isn’t a plan without a deductible less expensive?



In 2018 Georgia has 24 different prescription drug plans. Some #PartD plans have a deductible, others do not.

In many cases your drugs may have a lower #copay and lower annual out of pocket cost when you choose a plan with a #deductible. Premiums are usually less as well when compared to plans that do not have a deductible.

Roughly 6% of Medicare beneficiaries will ever enter the #donuthole. Many people can actively monitor their drug plan and avoid the donut hole completely.

Every #drugplan has a #formulary. The formulary let’s you know which drugs are covered by the plan, which are not.

The formulary also determines your copay.

Every Part D plan is approved by Medicare and each one is required to cover roughly 600 different drugs.

You have questions. We have answers.

Additional reading
https://www.medicare.gov/part-d/coverage/part-d-coverage.html

https://www.medicare.gov/Pubs/pdf/11136-Pharmacies-Formularies-Coverage-Rules.pdf

https://www.ncoa.org/wp-content/uploads/part-d-drug-coverage-rules.pdf



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