How Do Prescription Drug Plans Work?

Here is important information you need to know about owning a prescription drug plan:


  • Annual Deductible — There is a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $415 in 2019. You will pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.
  • Initial Coverage — During initial coverage, you pay a copay for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copy amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2019, the initial coverage cap is $3,820. After you and the insurance company together have paid this amount, then you enter the coverage gap.
  • The Coverage Gap – During the coverage gap, you will still generally have significant discounts for generic medications. Typically, you will pay 25% for name brand medications and 37% for generics. Your gap spending will continue until you have paid $5100 out of your own pocket in 2019.
  • Catastrophic Coverage – If you should spend past the coverage gap, your plan will begin to pay 95% of the costs of your formulary medications for the rest of the year.

How would I enroll?

Fill out the form and we will be in contact soon or press the "Click to Call" button above to call us today!


See Which Plans Are In Your Area Today

We are not connected with or endorsed by the United States government or the federal Medicare program - nor is any other agent.

Med Plan Advisors Copyright 2021 -- All Rights Reserved

Phone: 810-432-0525 | 888-465-0235

Email: info@medplanadvisors.com

*We do not offer every plan available in your area. Currently we represent over 30 organizations nationally, which vary the number of products we offer in your area. Please contact Medicare.gov or 1800Medicare to get information on all of your options.

*While the Center for Medicare and Medicaid Services (CMS) is requiring us to add this disclaimer, please note that we will discuss all plans available in your area, helping you choose the most appropriate plan to fit your needs.