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IDOI > Medicare and SHIP > Medicare Prescription Drug Coverage Medicare Prescription Drug Coverage

Part D Standard Benefit Design Parameters

2012 2013 2014
Deductible -
(after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit.		  $320 $325  $310
Initial Coverage Limit -
Coverage Gap (Donut Hole) begins at this point. (The Beneficiary pays 100% of their prescription costs up to the Out-of-Pocket Threshold).		 $2,930 $2,970 $2,850
Total Covered Part D Drug Spending including the Coverage Gap -
Catastrophic Coverage starts after this point.		 $6,657.50 $6,733.75 $3,605
Out-of-Pocket Threshold -
This is the Total Out-of-Pocket Costs including the Donut Hole.		 $4,700 $4,750 $6,455

** The Catastrophic Coverage is the greater of 5% or the values shown in the chart above. In 2014, beneficiaries would be charged $2.55 for those generic or preferred multisource drugs with a retail price under $51 and 5% for those with a retail price greater than $51. As to Brand drugs, beneficiaries would pay $6.35 for those drugs with a retail price under $127 and 5% for those with a retail price over $127.

Catastrophic Coverage Benefit

  2012 2013 2014
 Generic Drugs  $2.60 $2.65**  $2.55**
 Brand Name Drugs  $6.50 $6.60**  $6.35**

**The Catastrophic Coverage is the greatest of 5% or the values shown in the chart above.

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