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For Pharmacists > Medicare Shortcuts

Medicare Summary

 

How the Medicare part D payment plan will work

1. Patients will pay the first $250 of their drugs (deductible) each year they are enrolled in Medicare Part D.
2. Additionally a monthly premium will be charged to the patient, some approximate it at $35-$37 dollars per month.
3. After the first $250 spent on drugs Medicare will pay 75% of drug costs. They will pay 75% of drug cost up to $2,250.
4. From $2,251 to $5,100 in drug cost the patient pays 100% of that cost.
5. Once a patient's medications cost more than $5,101 Medicare will pay 95% of all drug costs thereafter.

Annual Drug Costs	Patient Pays	Medicare Pays
Up to $250 (annual deductible)	Monthly premium + 100% of drug costs	Nothing Nothing
$251 and $2,250	Monthly premium + $250 deductible + 25% coinsurance for drug costs	Nothing Nothing 75%
$2,251 and $5,100	Monthly premium + $750 ($250 deductible + $500 coinsurance for drugs $251 - $2,250)	Nothing $1,500
	+ 100% (for drugs $2,251 - $5,100)	Nothing
Over $5,101	Monthly premium + $3,600 ($250 deductible + $500 coinsurance for drugs $251 - $2,250 + $2,850 for drugs $2,251 - $5,100)	Nothing $1,500
	+ $2 for generics and $5 for brand-name drugs, Or 5% coinsurance for any drug (whichever is greater)	95%

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Updated March 7, 2008
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