|
In addition to paying your monthly premium, you pay these costs each year when using your benefit:
|
You Pay
|
Plan Pays
|
| You pay the first $295 of the cost of covered drugs—this is the annual deductible. |
$295
|
$0
|
| You pay 25% of the drug cost—your coinsurance—for the next $2,405 in covered drugs. |
$601.25
|
$ 1,803.75
|
| You pay 100% for the next $3,453.75 in covered drugs—this is the coverage gap. |
$3,453.75
|
$0 |
|
At this point, you have paid $4,350 in true out-of-pocket costs. You are now eligible for catastrophic coverage.
|
Total
$4,350
|
Total
$1,803.75
|
| You pay the greater of 5% of the cost of covered drugs or a minimum of $2.40 for a generic drug and $6.00 for a brand name or specialty drug—this is the catastrophic coverage. |
5%
No limit
|
95%
No limit
|