Future Financial Resource Group
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Wisconsin Medicare Insurance

How Much Will I Pay for a Medicare Part D Plan?

There is no single monthly premium for Part D prescription drug coverage, and differences among plan benefits can create wide variation in total costs. Under the standard benefit model established by federal law, you will pay:

  • A monthly premium.
  • An annual deductible before coverage begins.
  • A part of the cost of each prescription such as a flat co-payment or percentage, up to a pre-defined limit, during the initial coverage period.
  • A percentage of the costs in the Coverage Gap.
  • A nominal amount under Catastrophic Coverage.

In 2015 the cost for generics in the Gap or "donut hole" will be 65% of the drug's cost, and for Brand Name drugs you will pay 45% of the total drug cost. This is accomplished by requiring pharmaceutical companies who wish to be a part of the program to cover 50% of the cost for Brand name drugs and for the Part D insurance company to cover the percentage over 50%. This gap will continue to reduce until 2020 when your total cost in the Gap will be 25%.

Catastrophic Coverage begins after your total out of pocket drug costs for one year reach $4700 and ends at the end of the calendar year. To get this amount in 2015, you add together what you paid in the Initial Coverage period, the 65% you pay for generics in the Coverage Gap and 95% of the cost of Brand name drugs in the Coverage Gap. When you reach Catastrophic Coverage, you will pay the greater of 5% of the cost or $2.65 co-pay for generics, including Brand name drugs treated as generics, and a co-pay of $6.60 for all other drugs. Most people do not reach this level.

The federal government subsidizes the Part D program. Due to limited income and financial resources, some people may qualify for the Medicare Part D Low Income Subsidy, known as "Extra Help". You can find out more about Extra Help from your Social Security office. Also, beginning in 2011 people with incomes above a certain level pay a surcharge for Part D drug coverage on top of plan premium.

Prescription Drug Plan costs among different plans can vary widely for many reasons, and finding a plan that fits your needs can lower your overall costs. FFRG has experienced agents that can assist you with this process.




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Medicare Supplement Insurance Plan Disclosures

Neither Future Financial Resource Group nor the Medicare Supplement insurance policies it sells are connected with or endorsed by the U.S. government or the federal Medicare program.

Plans may be available to persons eligible for Medicare by reason of disability. All plans may not be available in your state/area. Call to receive complete information including benefits, costs, eligibility, requirements, exclusions and limitations.

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