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Agency Blog

The Four Stages Of Coverage Of Medicare's Prescription Drug Plans

8/16/2021

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​Nothing is avoidable in life. Just like others, you tend to get sick from time to time. Also, buying prescription drugs can hurt your pocketbook. If you're not ready to shoulder these expenses. It's a good thing that Medicare covers prescription drug plans if you run short on funds. Below are the four stages of its coverage: 
  1. Coverage of Annual Deductible 
    This coverage starts when your first prescription of the plan is issued for the year. Initially, you'll have to pay for the entire cost of your prescribed drugs. You'll have to do this until your payment becomes the same amount as your deductible's amount. Certain deductibles may only apply to medications in specified categories. 

  2. Initial Coverage Commences 
    Your initial coverage starts right away if your coverage plan does not have a deductible. This case applies when your prescription becomes the same amount as your deductible. Your insurance plan pays for some of the prescribed drugs you buy. Such is the case as long as that medication is included in the list of covered drugs. You then pay for the other portion as a copayment or coinsurance.

  3. A Gap for Coverage is Present 
    The gap in your coverage becomes present when you spend $4130 in total for your prescribed drugs in your plan. Not every person's prescription drug plan is covered in the coverage gap. There is a limit on the number of people whose medications are covered here. If you're covered, though, you'll co-pay 25 percent for the plan's branded meds and 25 percent for covered generic drugs. 

  4. Catastrophic Coverage Happens 
    Catastrophic coverage commences when you spend $6550 out-of-pocket costs for prescribed drugs covered. When the catastrophic coverage is in effect, you'll pay a low coinsurance or copayment fee. That Medicare sets for every prescription drug covered. The insurance plan and the government pay for the other fees. Approximately 95 percent of the price value of your prescription drug plan. 

Conclusion 
No person can tell the future. So even if you're not taking any medication right now, think about prescription drug coverage. Prescription drug coverage is optional, though, but anyone with Medicare can get it. If you decide to get it at a later time, you're likely going to pay a late enrollment fee. You'll need to pay this fine at this time as you have prescription drug coverage. 

At Medicare Simplified KC, we do our best to ensure that our clients are well-protected with affordable and comprehensive policies. We make sure to go the extra mile to help you with your needs. To learn more about how we can help you, please contact our agency at (816) 701-6661 or Click Here to request a free quote.
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