Your Part D costs (including premiums, deductibles, and coinsurances or copayments) can change every year. Each fall, your plan should send you an Annual Notice of Change (ANOC) to inform you of any changes for the coming year. Your plan cannot change your deductible or premium during the plan year, but the amount you pay for your drugs can change during the year based on which coverage period you are in. The chart below provides general Medicare drug costs for 2023.
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| Medicare Part D costs | ||||
| In 2023, you will pay: | ||||
| Monthly premium | Varies by plan. Average national premium is $32.74. People with high incomes have a higher Part D premium. | |||
| Annual deductible | Varies by plan. Cannot be more than $505 if you do not have Extra Help. For those with full Extra Help: $0For those with partial Extra Help: $104 or your plan’s standard deductible, whichever is lower | |||
| Coinsurance/copays if you do not have Extra Help | Vary by plan and by drug within plan. In most plans, after spending usually $4,660 in total drug costs, you reach the coverage gap. During the coverage gap you will have to pay 25% of the cost of your drugs. In all plans, after spending $7,400 out of pocket, you will leave the coverage gap and reach catastrophic coverage. During this period, you will pay 5% of the cost for each of your drugs, or $4.15 for generics and $10.35 for brand-name drugs (whichever is greater). | |||
| Coinsurance/copays if you have Medicaid and/or Extra Help | If you have Medicaid and your income is below 100% of the federal poverty level (FPL) ($13,590/year in 2023 for individuals and $18,310/year for couples), you will pay $1.45 for generics and $4.30 for brand-name drugs. After spending $10,516.25 in total drug costs, you will reach catastrophic coverage and pay $0 for each drug for the rest of the calendar year. If you have full Extra Help, you will pay $4.15 for generics and $10.35 for brand-name drugs. After spending $10,516.25 in total drug costs, you will reach catastrophic coverage and pay $0 for each drug for the rest of the calendar year.If you have partial Extra Help, you will pay 15% of the cost for each prescription or your plan’s standard coinsurance (whichever is lower). After spending $10,516.25 in total drug costs, you will reach catastrophic coverage and pay 5% of the cost for each of your drugs, or $4.15 for generics and $10.35 for brand-name drugs (whichever is greater). | |||
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Note: Many drug plans have preferred and non-preferred pharmacies in their network. You may pay less for your drugs at preferred pharmacies.