How Do Prescription Drug Plans Work?

Here is important information you need to know about owning a prescription drug plan:


  • Annual Deductible — There is a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $445 in 2021. You will pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.
  • Initial Coverage — During initial coverage, you pay a copay for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copy amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2021, the initial coverage cap is $4,130. After you and the insurance company together have paid this amount, then you enter the coverage gap.
  • The Coverage Gap – During the coverage gap, you will still generally have significant discounts for generic medications. Typically, you will pay 25% for name brand medications and 37% for generics. Your gap spending will continue until you have paid $6,550 out of your own pocket in 2021.
  • Catastrophic Coverage – If you should spend past the coverage gap, your plan will begin to pay 95% of the costs of your formulary medications for the rest of the year.

How would I enroll?

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Phone: 330-646-8008

Email: tom@rinkinsurancesolutions.com

Office: 3558 Lee Rd. Shaker Heights, OH 44120

3558 Lee Rd, Shaker Heights, OH 44120, USA



Rink Insurance Solutions is an independent insurance brokerage licensed in Ohio & Pennsylvania for life & health, and is specialized in Medicare. Rink Insurance Solutions is not affiliated with any government agency. Our services are at no-cost or obligation to the client. Medicare Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.