Jack's Blog on Medicare Plan Choices

In Medicare Part D, the prescription drug benefit program, there are four different phases of coverage in 2024, which can affect the prices of prescription drugs.

Deductible Phase: In this phase, you pay the full cost of your prescription drugs until you meet your plan’s deductible, which is the amount you must pay out-of-pocket before your plan begins to cover its share of the costs. In 2024, the standard Part D deductible is $545.  $40 increase over 2023.

Initial Coverage Phase: After you’ve met your deductible, you’ll enter the initial coverage phase, during which you’ll typically pay a copayment or coinsurance for each prescription drug. In 2024, the copayments or coinsurance amounts will vary depending on the specific drugs and plan you have. 

Coverage Gap (Donut Hole) Phase: Once your total drug costs (including what you and your plan have paid) reach a certain limit in 2024, which is $5,030, you’ll enter the coverage gap or donut hole phase. During this phase, you’ll typically pay no more than 25% of both generic and brand-name drugs.

Catastrophic Coverage Phase: Once your out-of-pocket costs (including what you and your plan have paid) reach a certain limit in 2024, which is $8,000, you’ll enter the catastrophic coverage phase. Starting in 2024, you will no longer has a copay during this phase.

Drug Phases will be completely different in 2025