How the Part D Prescription Program is Changing in 2024
The maximum deductible -$545. Most plans are using this maximum in 2024 for Tiers 3,4,5 and even some include Tier 2 generics under the deductible.
Initial Coverage Limits $5,030 In this phase, your Medicare Part D plan helps cover some of your prescription drug costs. You’ll typically pay a copay (a set amount of money) or coinsurance (a certain percentage of the cost for your prescription drugs) for every prescription you fill. PLEASE watch plans that have a % amount for Tier 3 Brand names. Eliquis is one of those that would cost almost $100/month in 2024 and this year it may have been only $47/month.
The initial coverage phase ends when the total amount spent by you and your plan on covered prescription drugs, including any deductible but not including your monthly premiums, the initial coverage limit threshold.
Out-of-Pocket maximum/catastrophic threshold-$8,000
HOW IT REALLY WORKS
According to Kff.org “In 2024, once Part D enrollees without low-income subsidies (LIS) have drug spending high enough to qualify for catastrophic coverage, they will no longer be required to pay 5% of their drug costs, which in effect means that out-of-pocket spending for Part D enrollees will be capped.
In 2024, the catastrophic threshold will be set at $8,000. This amount includes what Part D enrollees spend out of pocket, plus the value of the manufacturer price discount on brands in the coverage gap phase. At this amount, Part D enrollees who take only brand-name drugs in 2024 will have spent about $3,300 out of their own pockets and will then face no additional costs for their medications.”