The cost-sharing chart below covers what beneficiaries with Medicare Part D will pay for prescription coverage in each phase in 2021. This includes:
A deductible of up to $445 (this deductible varies by plan).
25% of the costs of their prescription drugs in the Initial Coverage Period (or up to $1,032.50 if they are in a plan with no deductible).
Up to $6,550 out-of-pocket expenses before the beneficiary reaches the Catastrophic Benefits Period. Once they hit this threshold, the Medicare beneficiary will pay either 5% coinsurance or $3.70 copay for generic medications, and $9.20 for brand-name drugs.
*Most Part D plans are not standard plans. This means calculating TrOOP costs during the initial deductible and ICP varies by plan. Source: 2021 Call Letter (p. 71) at: 2021 Call Letter.