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Medicare Prescription Drug Coverage

Part D Standard Benefit Design Parameters

 

  2018 2019 2020 2021
Deductible -
(after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit.
$405 $415 $435 $445
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).
$3,750 $3,820 $4,020 $4,130
Total Covered Part D Drug Spending including the Coverage Gap -
Catastrophic Coverage starts after this point.
$7,508.75 $7,653.75 $9,038.75  $9,313.75
Out-of-Pocket Threshold -
This is the Total Out-of-Pocket Costs including the Donut Hole.
$5,000 $5,100 $6,350 $6,550

** Catastrophic coverage is when you will pay 5% of the cost of each drug, or $3.60 for generics and $8.95 for brand-name drugs (whichever is greater).

 

Catastrophic Coverage Benefit

  2018 2019 2020 2021
 Generic Drugs $3.35** $3.40** $3.60** $3.70**
 Brand Name Drugs $8.35** $8.50 $8.95 $9.20


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

(updated 11/20)

Compare Medicare Prescription Drug Plans

Request for Medicare Part D Drug Plan Comparison (2/21),  Complete this printable form for a free Part D Drug Plan Comparison.