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Medicare Part D Terms

Medicare Part D Terms

Coverage Phases


Deductible Phase

Amount you must pay each year for your prescriptions before your Medicare Prescription Drug Plan begins to pay its share of your covered drugs.

Once you reach your full deductible...


Initial Coverage Phase

You’re only responsible for a copay for each prescription-“it’s a fixed amount you pay for your medication.

Once you and your plan spend a combined amount determined by Medicare...


Coverage Gap Phase

You’ll be responsible for a higher out-of-pocket payment in this phase-also known as the donut hole.

Once your out-of-pocket costs reach the upper limit of the coverage gap...


Catastrophic Phase

You’ll pay for a much smaller portion of your prescription drug costs for the rest of the year.


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