How Medicare Part D Cost Sharing Works

Medicare Part D (Prescription Plans) has different stages of cost-sharing until you reach a set limit on out-of-pocket costs for the year. The limit is $4,020 in 2020. After that, your plan pays most of the cost of your drugs for the rest of the year.

Co-pays, co-insurance amounts and your plan deductible, if any, count as out-of-pocket costs. Premium payments do not.

Part D cost-sharing stages are explained below. The costs shown are for 2020. You may not go through every stage in any given year. If you get Extra Help from Medicare for Part D costs, the coverage gap stage doesn’t apply to you.

Annual Deductible:

Initial Coverage:

Coverage Gap (Donut Hole):

Catastrophic Coverage:

To learn more visit Medicare Part D