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 to find out what you need to know about drug deductibles.
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. Deductibles are primarily understood as the amount of money you must spend out of pocket first before your insurance kicks in. After you reach your deductible, you usually pay a flat rate (copayment) or percentage (coinsurance) of the medication cost.
The highest Medicare drug deductible in 2023 is $505. However, many plans (both Medicare Advantage plans and Medicare Part D standalone Prescription Drug Plans) have lower deductibles available, 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!
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, the deductible often applies to more expensive medications, such as tier 3, 4, or 5 medications.
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 satisfy your plan’s deductible (if it has one) before your insurance coverage kicks in.
If you're a RetireMed client and have questions about your drug deductible, schedule a call with your client advisors today!
If you are not currently a RetireMed client and have questions about Medicare, we encourage you to schedule a call with one of our advisors. We’re here to walk you through all things Medicare!