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2022 Out-of-Pocket costs |
- Beneficiary pays a $480 Deductible
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- Beneficiary pays a 25% of Costs between $481-$4430
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- Cost of drugs purchased in the Coverage Gap without the Gap Discount (between $4431-$10012.5)
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Your annual out-of-pocket costs are estimated to be:
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- If your annual prescription costs are over $10,012.50:
- On the costs under $10,012.50, you pay as noted above (up to $7,050.00),
on the costs over $10,012.50, you pay (a) the greater of either 5% of the prescription
drug costs or $3.95 for generic prescription drugs and (b) $9.85 for brand-name
prescription drugs. Medicare Part D pays the lesser of either: 95% of the
prescription drug costs or the balance of the prescription drug costs.
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