Drug Coverage

• This covers the Drugs that are approved by the plan
• They USUALLY include
  • Medicare Part B Drugs
    • Chemotherapy
    • Other Part B Drugs
  • Medicare Part D Drugs
    • Prescription Drugs
      • Drugs Tiered 1-6
        • Determined by the plans formulary
    • 4 Phases
      • Deductible
        • Member must pay full cost of prescriptions until deductible is met. (premiums do not count)
      • Initial Coverage 
        • Starts right away if the plan has no deductible. Or, when the prescription payments you have made equal your plan’s deductible. (2024 limit = $5,030.00)
      • Coverage Gap
        • Member pays 25% of drug cost until the amount spent reaches $8,000.00 for the year.
      • Catastrophic Coverage
        • Member pays $0 for the drugs