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 $505 in 2023. 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 2023, the initial coverage cap is $4,660. 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 25% for generics. Your gap spending will continue until you have paid $7,400 out of your own pocket in 2023.

  • 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?

Fill out the form and we will be in contact soon or press the "Click to Call" button above to call us today!


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Phone : (808) 758-5962 Email: marden@pbchawaii.com

"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. By submitting the information above, you agree to have a licensed insurance agent contact you in person, via text, email, or by phone about your Medicare Plan options."