A New Year, A New Drug Deductible

If you’ve previously had drug coverage on your Medicare plan, you may be familiar with the concept of a drug deductible. Not all Medicare plans have a drug deductible, but plans that do begin calculating your out-of-pocket contribution toward it at the beginning of each calendar year. Read more from our team for important facts about drug deductibles.

What is a drug deductible?

A drug deductible is the amount of money you must pay for certain medications before your plan begins to cover a portion of the cost. After you reach your deductible, you usually pay a flat rate (co-pay) or percentage (coinsurance) of the medication cost.

How much is my plan’s deductible?

The highest Medicare drug deductible in 2025 is $590. However, many plans (both Medicare Advantage plans and standalone prescription drug plans - Medicare Part D) have lower deductibles, and some have no drug deductible at all. 

At RetireMed, we offer a variety of Medicare plans to ensure you get the right coverage for your needs. Each plan is different, which means your costs could be different from a friend or relative. If you would like to better understand your prescription coverage, contact us!

Does my deductible apply to all my medications?

In some cases, your deductible will apply to all medications. But it’s very common for a deductible to apply only to certain drug tiers on the plan’s formulary (list of covered drugs). In these situations, lower-cost medications will often be exempt from the deductible. Generally, a deductible often applies to more expensive medications, such as tier 3, 4, or 5 medications.

A Few Facts About Deductibles

Here are a few important things to know about drug deductibles:

•    Medicare plans function on annual cycles, so plans reset every January.
•    Medicare plans may change from year to year, including the plan’s deductible amount.
•    Each year, you must meet your plan’s deductible (if it has one) before your insurance coverage kicks in.

Have questions?

If you have questions about Medicare, we encourage you to speak with one of our advisors. We’re here to walk you through all things Medicare! Contact an advisor at 937.915.3563 or schedule a call.

Already a RetireMed client? If you have any questions about your plan, call 877.222.1942 or schedule a call with a client advisor. 

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