Ilovebenefits’s Blog

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Medicare Part D (Drug) Cost – premiums, deductibles …

Editor’s note: As Congress moves to impacting Medicare Advantage Plans that essentially eliminate deductibles, coinsurance, and some donut hole costs in favor of copays — here is what seniors will be subject to:


 Medicare Part D Increases in Subsequent Years
Premiums for Medicare Part D (the prescription drug benefit set forth under the MMA) are variable by the plan vendor, with premium rates set on an annual basis. Cost sharing is subsidized for qualified Medicaid/Medicare crossovers and specified low-income beneficiaries. The MMA allows for the deductible, and variable coinsurance coverage levels to increase on an annual basis in subsequent years. The standard benefit and cost sharing for 2010 is:

  • Annual Deductible of  $310
  • 25% Coinsurance for the cost of covered drugs between $311 and $2,830
  • 100% Coinsurance (no plan coverage) of the cost of covered drugs between $2,831 and $6,153.75
  • The Maximum beneficiary annual out of pocket, which determines the upper limit of no plan coverage as stated above is $4,550
  • 5% coinsurance of the cost of covered drugs above $6,440 (or a copayment of $2.50 for covered generics and $6.30 for covered brand-name drugs—whichever is greater).

October 1, 2009 - Posted by | Federal Government, healthcare | , , , ,

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