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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 it at the beginning of each calendar year. The deductible dollar amount may also change from year to year.

What is a drug deductible?

A drug deductible is the amount of money you pay for certain medications before your plan begins to cover some 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

How much is my plan’s deductible?

The highest Medicare drug deductible in 2022 is $480. However, many plans (both Medicare Advantage plans and stand-alone Prescription Drug Plans) have lower deductibles available, and some plans have no drug deductible at all!

At RetireMed, we offer a variety of plans to ensure every client finds the right coverage for their 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 the deductible apply to all medications?

In some cases, the deductible will apply to all medications. But it’s very common for the deductible to apply only on certain drug tiers. In these situations, lower-cost medications will often be exempt from the deductible. The deductible usually applies to more expensive medications, such as tier 3, 4, or 5 medications.

A Few Facts About Deductibles

  • Medicare plans function on annual cycles, so plans restart every January.
  • Medicare plans may change from year to year, including the plan’s deductible amount.
  • At the beginning of each year, you must satisfy your plan’s deductible, if it has one.

Local Medicare Help in Dayton and Cincinnati

Are you a current client with questions about your drug deductible? Reach out to our client team by scheduling a call.

If you are not currently a RetireMed client and have questions about your Medicare plan options, please schedule a call with a program advisor. We’re here to walk you through all things Medicare.