The Costs Associated With Part D.

• The Part D Monthly Plan Premium.
• Out-of-Pocket Costs Like Deductibles & Copays Outlined In The Plan, Along With The CMS Part D Coverage Stages.
• Any Late Penalty’s Incurred From Not Obtaining Part D Coverage When First Eligible.

Understanding CMS Medicare Part D Coverage Stages.

• Annual Deductible: At this stage, drugs are paid by the beneficiary until the deductible is met. Not all Part D Plans have a deductible. The coverage starts with the first filled prescription if the plan does not have a deductible. 
• Initial Coverage: At this stage, the beneficiary pays a copay, and the plan pays the rest. This stage continues until the *Total Drug Costs reach the amount set by CMS for that calendar year.
• Coverage Gap (Donut Hole): In this stage, after the *Total Drug Costs reach the amount set by CMS for that calendar year, the copay becomes 25% of the costs for brand-name and generic drugs. This stage continues until the *Total Out-of-Pocket Costs reach the amount set by CMS for that calendar year.
• Catastrophic Coverage: In this stage, after the *Total Out-of-Pocket Costs reach the amount set by CMS, only a small copay or coinsurance is owed. This stage continues for the rest of the calendar year.

*Total Drug Costs: Equals the amount a beneficiary pays and what the plan pays for prescription drugs each calendar year. It does not include the plan premiums.

*Total Out-of-Pocket Costs: Equals the amount the beneficiary pays, including the deductible for prescription drugs each calendar year. The total out-of-pocket costs also include the discount paid by the drug manufacturers during this stage. It does not include the plan premiums.

*The Part D deductible and coverage gap do not apply when a person qualifies for Extra Help.