| Thu, Nov 17, 2016 @ 09:00 AM

3 Medicare Part D Costs You May Not Know About

Posted by Medicare Made Clear

medicare-drug-costs-for-seniorsMany people take at least one prescription drug every day. That makes drug costs a top concern when choosing a Medicare Part D plan.

Medicare Part D costs usually include premiums, deductibles, and co-pays. The specific amounts paid vary depending on the plan. And there are also certain situations that may affect what you pay.

Here are 3 Part D costs that you may want to consider as you review your current plan or look into switching to a different plan.

  1. Split-Tier Deductibles

Most plans have a tiered formulary (drug list). Tiered formularies may have deductibles for certain tiers and not for others. There may be no deductible for tier 1 drugs, for example, and a deductible for drugs in higher tiers. Coverage for a tier 1 drug in this case would start with the first prescription filled. Coverage for higher tier drugs would kick in after the deductible was met.

Part D plans may have a no deductible, a split-tier deductible, or one deductible that applies to all drug tiers. It’s important to review plan materials and understand the costs when selecting a plan.

Part D plans in your area may vary quite a bit. You want to make sure to choose a plan that covers the drugs you take at a cost you’re comfortable with.

  1. Medicare Part D Coverage Gap (Donut Hole)

You may know about the Part D coverage gap and that you pay more for your drugs if you enter it. But did you know your costs in the gap are going down?

You will pay 40% of your plan’s cost for covered brand-name drugs and 51% of your plan’s cost for covered generic drugs in 2017 (down from 45% and 58% in 2016).

Most people don’t enter the coverage gap because their drug costs aren’t high enough. Those who do enter the coverage gap can look forward to more savings in 2017 and each year beyond until 2020 when the gap will close.

  1. Extra Part D Premium

Most Medicare Part D plans charge a monthly premium. Premiums vary from plan to plan.

People with incomes over a limit set by Medicare must pay an extra amount that’s added to their Part D plan premium. The income limit is $85,000 for single individuals and married individuals filing separately. It’s $170,000 for married couples filing jointly.

The extra amount paid varies depending on the tax-reported income. It’s added to the base plan premium each month.


You may have many Medicare Part D plans to choose from. You may also choose a Medicare Advantage (Part C) plan that includes drug coverage. Part D costs are just one consideration when choosing a plan – but an important one.

Remember, you can change your Medicare Part D or Medicare Advantage (Part C) plan during Medicare Open Enrollment, Oct. 15 – Dec. 7. Making changes is simple. Usually you can just enroll in a new plan if you choose to. You will automatically be dis-enrolled from your previous plan.

Related Content

Money-Saving Tips for Maximizing Your Medicare Part D Plan

More about Prescription Drug Coverage

Medicare Part D Can Be Costly. Financial Assistance May Help


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For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.


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