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FAQ(s) found under  Other Q1Medicare.com Questions Showing 53 of 82 Prev  |  Next

What are the out-of-pocket costs for Medicare prescription drug coverage?
Date Added : 2007-09-19 

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When you get Medicare prescription drug coverage, you pay part of the costs and Medicare pays part of the costs. You pay a premium each month to join the drug plan. If you have Medicare Part B, you also pay your monthly Part B premium. If you belong to a Medicare Advantage Plan or Medicare Cost Plan, the monthly premium you pay to the plan may increase if you add prescription drug coverage.

Your costs will vary depending on which plan you choose. Your plan must, at a minimum, provide a standard level of coverage as shown below. Some plans offer more coverage or lower premiums.

Standard Coverage (the minimum coverage drug plans must provide)

Effective January 1, 2007, for covered drugs you will pay

  • A monthly premium (varies depending on the plan you choose)
  • The first $265 per year for your prescriptions. This is called your deductible.

After you pay the $265 yearly deductible, here's how the costs work:

  • You pay 25% of your yearly drug costs from $265 to $2,400, and your plan pays the other 75% of these costs, then
  • You pay 100% of your next $3,051.25 in drug costs, then
  • You pay a coinsurance amount (like 5% of the drug cost) or a copayment (like $2.15 or $5.35 for each prescription) for the rest of the calendar year after you have spent $3,850 out-of-pocket. Your plan pays the rest.
(Source: U.S. Department of Health & Human Services)

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Related FAQs In This Category
•  I have prescription drug coverage from my former employer. Will I be able to keep it or will Medicare prescription drug coverage replace it?
•  I have requested automatic premium deduction from my monthly Social Security benefit. How long will it take for the automatic deduction to start?


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