Costs for Medicare drug coverage
Medicare Part D Costs & Coverage
After you reach your yearly deductible, you may still be responsible for certain out-of-pocket costs, even after your Medicare plan has covered its share. This may include coinsurance and copayments. If you have to pay a coinsurance, you will be responsible for a percentage of the cost of the drug. For example, you may owe a 15% coinsurance each time you fill a particular prescription. If you have to pay a copayment, you will be responsible for paying a set amount for medications on a certain tier as determined by your Medicare plan. As mentioned, Medicare plans that cover prescription drugs place covered drugs into cost tiers, and medications on higher tiers may have higher copayments and coinsurance costs. Your cost sharing may also vary depending on whether you’re taking brand-name or generic medications; generics tend to have lower costs than brand-name prescription drugs.
What Are the Costs for Medicare Part D?
If you’re enrolled in a Medicare Part D Prescription Drug Plan, you may qualify for a low-income subsidy, also called the Extra Help program. To be eligible for the Extra Help program, you need to reside in one of the 50 United States or the District of Columbia and have limited resources including such things as bank accounts, stocks, and bonds ($13,640 for an individual, $27,250 for a couple living together) and a limited annual income ($17,820 for an individual, $24,030 for a married couple living together). Please note that these are the criteria for 2016 and might change for 2017. In such a case, you can receive help with your monthly premiums, annual deductibles, and prescription copayments. You can apply online at www.socialsecurity.gov/extrahelp or call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778). Social Security representatives are available Monday through Friday, from 7AM to 7PM.
Extra Help with Medicare Prescription Drug Plan Costs
Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.