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Indiana Department of Insurance

Indiana Department of Insurance

IDOI > Medicare and SHIP > Medicare Prescription Drug Coverage Medicare Prescription Drug Coverage

Part D Standard Benefit Design Parameters

 

  2013 2014 2015  2016 2017
Deductible -
(after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit.
$325  $310  $320 $360 $400
Initial Coverage Limit -
Coverage Gap (Donut Hole) begins at this point. (The Beneficiary pays 100% of their prescription costs up to the Out-of-Pocket Threshold).
$2,970 $2,850  $2,960 $3,310 $3,700
Total Covered Part D Drug Spending including the Coverage Gap -
Catastrophic Coverage starts after this point.
$6,733.75 $6,455  $6,680 $7,062.50 $7,425
Out-of-Pocket Threshold -
This is the Total Out-of-Pocket Costs including the Donut Hole.
$4,750 $4,550  $4,700 $4,850 $4,950

** The Catastrophic Coverage is the greater of 5% or the values shown in the chart above. In 2014, beneficiaries would be charged $2.55 for those generic or preferred multisource drugs with a retail price under $51 and 5% for those with a retail price greater than $51. As to Brand drugs, beneficiaries would pay $6.35 for those drugs with a retail price under $127 and 5% for those with a retail price over $127.

 

Catastrophic Coverage Benefit

  2013 2014 2015  2016 2017
 Generic Drugs $2.65**  $2.55**  $2.65** $2.95** $3.30**
 Brand Name Drugs $6.60**  $6.35**  $6.60** $7.40** $8.25**


**The Catastrophic Coverage is the greatest of 5% or the values shown in the chart above.

View a complete list of Medicare Prescription Plans in Indiana (2016) (updated 1/28/16)

Compare Medicare Prescription Drug Plans

Request for Medicare Part D Drug Plan Comparison,  Complete this printable form for a free Part D Drug Plan Comparison.