For 2021 Medicare Part D Costs, most drug plans charge a monthly fee that varies by plan. You pay this in addition to the Part B premium. If you’re in a Medicare Advantage Plan (Part C) or Medicare Cost Plan with drug coverage, the monthly premium may include an amount for drug coverage.
Deductibles vary between Medicare drug plans. Some Medicare drug plans don’t have a deductible.
Once your deductible is met, you’ll pay a coinsurance (copay) for prescription drugs. Note that the amount of your copay may change during the benefit period, if the drug price fluctuates.
Once you and your plan have spent $4,130 on covered drugs in 2021, you’re in the coverage gap (a temporary limit on what the plan covers). Even though you’ll only pay 25% for both brand name and generic drugs at this point, almost the full price of the drug (except for what the plan pays) will count as out-of-pocket costs to help you get out of the coverage gap.
Once you reach your threshold ($6,550), you are out of the coverage gap (donut hole) and you’ll automatically get catastrophic coverage. This assures you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year.