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How much will I have to pay for my drugs with the Medicare drug benefit?

Section VI.b. Part D Cost Overview
Question 1 of 5 (use "Last" or "Next" buttons to see more)
Last Update: January 21, 2010

Your costs with your Medicare drug plan will change every year. Each fall, your plan will send you information tell you how costs will change for the next year. The chart below shows you general Medicare drug costs for 2010.

You Will Pay In 2010
Monthly Premium Varies by plan. Average national premium is $31.94.
Annual Deductible Varies by plan. Cannot be more than $310 if you do not have Extra Help.

$0 if you have Full Extra Help.

$63 or your plan's standard deductible (whichever is cheaper) if you have Partial Extra Help.

Coinsurance/ Copayments If You Do Not Have Extra Help Varies by plan and by drug within plan.

After spending a pre-determined amount in total drug costs (usually $2,830), you may have to pay 100 percent of the cost of your drugs until coverage begins again (coverage gap).

In all plans, after you have spent $4,550 out of pocket (not including premium or the costs of drugs not on your plan's list of covered drugs or that you bought in a pharmacy outside the plan's network), you will reach "catastrophic coverage" when you will pay 5 percent of the cost of each drug, or $2.50 for generics and $6.30 for brand-name drugs (whichever is greater).

Coinsurance/ Copayments If You Have Extra Help If you have Medicaid and your income is below 100 percent of the Federal Poverty Level ($10,836 a year in 2010 for individuals and $14,580 a year for couples): $1.10 for generics and $3.30 for brand-name drugs. After your total drug costs reach $6,440, you will get catastrophic coverage and pay $0 for each drug for the rest of the calendar year.

If you have Full Extra Help: $2.50 for generics and $6.30 for brand-name drugs. After your total drug costs reach $6,440 you will get catastrophic coverage and pay $0 for each drug for the rest of the calendar year.

If you have Partial Extra Help: 15 percent of each prescription or your plan's standard coinsurance (whichever is cheaper). After your total drug costs reach $6,440, you will get catastrophic coverage and pay $2.50 for generics and $6.30 for brand-name drugs for the rest of the calendar year.


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Why am I paying a different amount for my drugs this month?

Will I pay a different amount for my drugs throughout the year if I have Extra Help?

What if I cannot afford copayments for my prescription drug plan (with or without Extra Help)?

 
LINKS
State Health Insurance Assistance Program (SHIP) Directory

 
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