Monthly premiums for Part D coverage vary by plan. In some states, plans can cost as little as $10, and they can go as high as $170 or more in other areas. Premiums are determined in large part by the formulary, or list of prescription drugs covered under the plan.
Medicare does impose an adjusted premium for those with higher incomes. For 2023, if you earn more than $97,000 annually (for individuals) or $194,000 (married filing jointly) then you will owe the Income Monthly Adjusted Amount (IRMAA).
When you purchase prescriptions at the pharmacy, those with Part D coverage will enjoy an affordable co-pay for the medication that your plan administrator negotiated for you. Medications are available in different tiers of pricing, with generic drugs generally being the most affordable.
Finally, you might also be subject to an annual deductible. This is the amount you must pay for your prescription medications before your insurance benefits kick in to cover the rest (except for co-pays). Medicare sets a threshold for deductibles each year, and insurance companies cannot charge more than that limit (although they can charge less). For 2023, the maximum deductible allowed for Part D coverage is $505.
Other notable cost information:
The initial coverage limit for 2023 is $4,660.
Coverage gap stage is 25% coinsurance until a person reaches $7,400 TROOP.
Catastrophic coverage copays are $4.15 for generics and $10.35 for non generic drugs (Or the member pays 5% coinsurance whichever is higher).