Stages of Medicare Part D Prescription Drug Payments
|
Stages
|
Drug Costs
|
Member Pays
|
Plan Pays
|
|
Stage 1 Deductible
|
$0 - $295
|
$295
|
$0
|
|
Stage 2 Initial Coverage
|
$295 - $2,700
|
$601
|
$1,804
|
|
Stage 3 Coverage Gap
|
$2,700 - $6,154
|
$3,454
|
$0
|
|
Stage 4 Catastrophic Coverage
|
Greater than $6,154
|
5%
|
95%
|
The most an individual will have to pay is $4,350 of the total cost of the medications taken
($295 + $601 + $3,454 = $4,350) not counting premiums and catastrophic coinsurance costs.
A member is eligible to receive the $1,200 coverage gap subsidy, if they are enrolled in one
of the 18 plans that have agreed to provide it.
Medicare Part D Benefit with the $1,200 Maryland SPDAP Coverage Gap Subsidy
|