Medicare
Know Your Options
Selecting the right Medicare plan is complicated. If you select the wrong plan you may have to wait an entire year to change to one that better meets your needs. We are here to help and our services are provided at no cost to our clients.
Whether you’re new to Medicare, getting ready to turn 65, or preparing to retire, you’ll need to make several important decisions about your health coverage. If you wait to enroll, you may have to pay a penalty, and you may have a gap in coverage.
Medicare Supplements
A Medicare supplement, sometimes called a Medigap policy, can help pay some of the costs that original Medicare doesn’t cover, like co-payments, co-insurance, and deductibles.
Enroll in a supplement plan when you’re first eligible. The best time to enroll is during your guaranteed acceptance period because you can buy any plan available, even if you have health problems. Your open enrollment period starts when you turn 64 1/2 or when you leave another group of medical coverage to join Medicare.
If you apply for Medicare supplement coverage after your guaranteed acceptance period, there’s no guarantee that an insurance company will approve your application if you don’t meet certain health criteria.
ABCs Of Medicare
Turning 65? Getting ready to retire? If so there are critical decisions you will have to make about your health coverage. Failing to do so within certain timelines could result in both penalties and gaps in coverage. Click the tabs below to see an overview of the different parts of Medicare that we can help you with.
What Does Original Medicare Cover?
Medicare Part A
- Inpatient Hospital Coverage
- Skilled Nursing Care in a facility (requires a minimum three-day prior hospitalization)
- Home Health Care
- Hospice
- Blood
MEDICARE PART A (HOSPITAL INSURANCE) – COVERED SERVICES PER BENEFIT PERIOD 2025
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital or skilled nursing facility for 60 consecutive days.
| Services | Benefit | Medicare Pays[1] | You Pay[1] |
|---|---|---|---|
| INPATIENT HOSPITALIZATION (admitted): Semi-private room and board, general nursing and miscellaneous hospital services and supplies | First 60 days | All but $1,676 deductible | $1,676 deductible |
| 61st to 90th day | All but $419 per day | $419 per day | |
| 91st to 150th day[2] | All but $838 per day | $838 per day | |
| Beyond 150 days | Nothing | All costs | |
| POST-HOSPITAL SKILLED NURSING FACILITY CARE: You must have been an inpatient in a hospital for at least 3 days, enter a Medicare-approved facility generally within 30 days after hospital discharge, and meet other program requirements.[3] | First 20 days | 100% of approve amount | Nothing |
| 21st to 100th day | All but $209.50 per day | Up to $209.50 per day | |
| Beyond 100 days | Nothing | All costs | |
| HOME HEALTH CARE (also see Part B): Medically necessary skilled care, home health aide services, medical supplies, etc. after a 3-day inpatient hospital stay for visits 1-100. | 100% part-time or intermittent nursing care and other services for as long as you meet criteria for benefits. | 100% of approved amount; 80% of approved amount for Durable Medical Equipment. | Nothing for services; 20% of approved amount for Durable Medical Equipment. |
| HOSPICE CARE: Full scope of pain relief and support services available to the terminally ill. | As long as doctor certifies need. | All but limited costs for outpatient prescription medications and inpatient respite care. | Limited cost sharing for outpatient prescription medications and inpatient respite care. |
| BLOOD | Blood | All but first three pints per calendar year | For first three pints[4] |
[1] These figures are for 2025 and are subject to change each year.
[2] Lifetime reserve days may be used only once.
[3] Neither Medicare nor Medicare Supplement (Medigap) insurance will pay for most nursing home care.
[4] To the extent the blood deductible is met under one part of Medicare during the calendar year it does not have to be met under the other part.
NOTE: The Medicare Part A premium is $0 for eligible beneficiaries. For those who are ineligible, the Medicare Part A premium is $518 per month for those who worked fewer than 30 quarters, or $285 per month for those who worked between 30 and 40 quarters.
Medicare Part B
- Outpatient Hospital Coverage
- Physician Services
- Outpatient Surgery and Services
- Durable Medical Equipment (DME), prosthetics, orthotics and supplies
- Home Health Care
- Preventative Services
- Blood
MEDICARE PART B (MEDICAL INSURANCE) – COVERED SERVICES PER CALENDAR YEAR 2025
| Services | Benefit | Medicare Pays[1] | You Pay[1] |
|---|---|---|---|
| MEDICAL EXPENSE: Physicians’ services, outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment, ambulance services, outpatient mental health services, etc. | First 60 days | All but $1,676 deductible | $1,676 deductible |
| CLINICAL LABORATORY SERVICES | Blood tests, blopsies, urinalysis, etc. | Generally 100% of approved amount. | Nothing |
| PREVENTATIVE BENEFITS | Preventative services & screenings | 100% for most; or 80% of approved amount (after $257 deductible), depending on test | Nothing for most; or $257 deductible 20% of approved amount, depending on test |
| HOME HEALTH CARE: Medically necessary skilled care, home health aide services, medical supplies, etc. after a 3-day inpatient hospital stay beginning with visit 101 or beginning day one if there is no previous hospital stay. | 100% part-time or intermittent nursing care and other services for as long as you meet criteria for benefits. | 100% of approved amount | Nothing |
| 80% of approved amount for Durable Medical Equipment. | $257 deductible[6] 20% of approved amount for Durable Medical Equipment | ||
| BLOOD | Blood | 80% of approved amount (after $257 deductible and starting with the 4th pint) | $257 deductible[6] First 3 pints plus 20% of approved amount for additional parts[8] |
The monthly Part B premium for 2025 is $185 (Premiums will be higher for individuals with annual incomes of $106,000 or more and married couples with annual incomes of $212,000 or more.)
[5] These figures are for 2025 and are subject to change each year.
[6] Once you paid $257 covered services, the Part B deductible does not apply to any other covered service(s) you receive for the rest of the calendar year.
[7] The amount by which a physician’s charge can exceed the Medicare approved amount is limited by law.
[8] To the extent the blood deductible is met under one part of Medicare during the calendar year, it does not have to be met under the other part.
Medicare Advantage Plans
Medicare Advantage Plans are offered by private insurance companies approved by Medicare. If you join a Medicare Advantage Plan you are still part of the Medicare program. However, your Part A and Part B benefits are provided by the Medicare Advantage Plan rather than Original Medicare.
These plans are required to cover all services approved by Medicare. Most Medicare Advantage Plans offer services in addition to Original Medicare and may also include Part D prescription drug coverage. Most Advantage Plans will be HMOs or PPOs.
Medicare benefits are administered by the Centers for Medicare and Medicaid Services (CMS)
What Is NOT Covered by Original Medicare Cover?
- Outpatient Prescription Medications
- Routine Dental Care
- Routine Vision Care and Eyeglasses
- Hearing Aids
- Foreign Travel
- Cosmetic Procedures and Treatments
- Long Term Care
The Inflation Reduction ACT (IRA)
Brings Big Changes
This year’s Medicare Advantage and Part D Annual Election Period (AEP) brings big changes thanks to the Inflation Reduction Act (IRA). Keep reading so you’ll know what to watch for with your plan this fall.
Medicare Enhancements in 2025
The IRA was passed in 2022 and was designed to help meet climate goals as well as to benefit many vulnerable populations – including Medicare beneficiaries. Changes to Prescription Drug Plans went into effect in 2023 with a cap of $35 on Part D covered insulin. In 2025, three more changes arrive for Medicare plans with prescription drug coverage – with notable consumer benefits.
Maximum annual out-of-pocket cost capped at $2,100.00
- After reaching your deductible, you pay 25% cost-sharing
- When you reach $2,100.00 out-of-pocket, you pay $0 for prescription drugs for the rest of the year
- Excludes drugs covered by Part B
No More “donut hole” coverage gap phase
- Now there is only the deductible, initial coverage phase and catastrophic (after you reach maximum out of pocket)
Spread out your prescription drug costs over the year
- This can smooth your costs, helping you to budget
- Example: You have one prescription that costs $300 every three month. You now have the option to pay $100 per month – the same $1,200 over a year.
Prepare for Your Plan Updates — Next Steps
Now more than ever, it’s important to watch for your plan’s Annual Notice of Changes (ANOC) letter. If you haven’t received this letter by the end of September, reach out to your plan. Standalone Part D plans and MAPD prescription drug coverage may see changes in 2025. Plan adjustments may include:
- Premium changes
- Updated copays on different tiers of drugs
- Drugs changing tiers or being removed from the plan
Make sure to weigh costs and benefits of any plan that includes Part D coverage.
What’s the Medicare Prescription Payment Plan?
The Medicare Prescription Payment Plan is a new payment option in the prescription drug law that works with your current drug coverage to help you manage your out- of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option. All plans offer this payment option and participation is voluntary.
If you select this payment option, each month you’ll continue to pay your plan premium (if you have one), and you’ll get a bill from your health or drug plan to pay for your prescription drugs (instead of paying the pharmacy). There’s no cost to participate in the Medicare Prescription Payment Plan.
What to know before participating
How does it work?
When you fill a prescription for a drug covered by Part D, you won’t pay your pharmacy (including mail order and specialty pharmacies). Instead, you’ll get a bill each month from your health or drug plan. Even though you won’t pay for your drugs at the pharmacy, you’re still responsible for the costs. If you want to know what your drug will cost before you take it home, call your plan or ask the pharmacist.
This payment option might help you manage your monthly expenses, but it doesn’t save you money or lower your drug costs.
How is my monthly bill calculated?
Your monthly bill is based on what you would have paid for any prescriptions you get, plus your previous month’s balance, divided by the number of months left in the year. All plans use the same formula to calculate your monthly payments.
Your payments might change every month, so you might not know what your exact bill will be ahead of time. Future payments might increase when you fill a new prescription (or refill an existing prescription) because as new out-of-pocket costs get added to your monthly payment, there are fewer months left in the year to spread out your remaining payments.
In a single calendar year (January – December), you’ll never pay more than:
- The total amount you would have paid out of pocket to the pharmacy if you weren’t participating in this payment option.
- The Medicare drug coverage annual out-of-pocket maximum ($2,100 in 2025).
The prescription drug law caps your out-of-pocket drug costs at $2,100 in 2025.
This is true for everyone with Medicare drug coverage, even if you don’t participate in the Medicare Prescription Payment Plan.
Will this help me?
It depends on your situation. Remember, this payment option might help you manage your monthly expenses, but it doesn’t save you money or lower your drug costs.
You’re most likely to benefit from participating in the Medicare Prescription Payment Plan if you have high drug costs earlier in the calendar year. Although you can start participating in this payment option at any time in the year, starting earlier in the year (like before September), gives you more months to spread out your drug costs.
This payment option may not be the best choice for you if:
- Your yearly drug costs are low.
- Your drug costs are the same each month.
- You’re considering signing up for the payment option late in the calendar year (after September).
- You don’t want to change how you pay for your drugs.
- You get or are eligible for Extra Help from Medicare.
- You get or are eligible for a Medicare Savings Program.
- You get help paying for your drugs from other organizations, like a State
- Pharmaceutical Assistance Program (SPAP), a coupon program, or other health coverage.
Who can help me decide if I should participate?
- Your health or drug plan: Visit your plan’s website, or call your plan to get more information. If you need to pick up a prescription urgently, call your plan to discuss your options.
- Medicare: Visit Medicare.gov/prescription-payment-plan to learn more about this payment option and if it might be a good fit for you.
- State Health Insurance Assistance Program (SHIP): Visit shiphelp.org to get the phone number for your local SHIP and get free, personalized health insurance counseling.
How do I sign up?
Visit your health or drug plan’s website, or call your plan to start participating in this
payment option:
- In 2024, for 2025: If you want to participate in the Medicare Prescription Payment Plan for 2025, contact your plan now. Your participation will start January 1, 2025.
- During 2025: Starting January 1, 2025, you can contact your plan to start participating in the Medicare Prescription Payment Plan anytime during the calendar year.
Remember, this payment option may not be the best choice for you if you sign up late in the calendar year (after September). This is because as new out-of-pocket drug costs are added to your monthly payment, there are fewer months left in the year to spread out your payments.
What to know if I’m participating
What happens after I sign up?
Once your health or drug plan reviews your participation request, they’ll send you a letter confirming your participation in the Medicare Prescription Payment Plan. Then:
- When you get a prescription for a drug covered by Part D, your plan will
automatically let the pharmacy know that you’re participating in this payment
option, and you won’t pay the pharmacy for the prescription. Even though you won’t pay for your drugs at the pharmacy, you’re still responsible for the costs. If you want to know what your drug will cost before you take it home, call your plan or ask the pharmacist. - Each month, your plan will send you a bill with the amount you owe for your prescriptions, when it’s due, and information on how to make a payment. You’ll get a separate bill for your monthly plan premium (if you have one).
How do I pay my bill?
After your health or drug plan approves your participation in the Medicare Prescription Payment Plan, you’ll get a letter from your plan with information about how to pay your bill.
What happens if I don’t pay my bill?
You’ll get a reminder from your health or drug plan if you miss a payment. If you don’t pay your bill by the date listed in that reminder, you’ll be removed from the Medicare Prescription Payment Plan. You’re required to pay the amount you owe, but you won’t pay any interest or fees, even if your payment is late. You can choose to pay that amount all at once or be billed monthly. If you’re removed from the Medicare Prescription Payment Plan, you’ll still be enrolled in your Medicare health or drug plan.
Always pay your health or drug plan monthly premium first (if you have one), so you don’t lose your drug coverage.
Call your plan if you think they made a mistake about your Medicare Prescription Payment Plan bill. If you think they made a mistake, you have the right to follow the grievance process found in your Member Handbook or Evidence of Coverage.
How do I leave?
You can leave the Medicare Prescription Payment Plan at any time by contacting your health or drug plan. Leaving won’t affect your Medicare drug coverage and other Medicare benefits. Keep in mind:
- If you still owe a balance, you’re required to pay the amount you owe, even though you’re no longer participating in this payment option.
- You can choose to pay your balance all at once or be billed monthly.
- You’ll pay the pharmacy directly for new out-of-pocket drug costs after you leave the Medicare Prescription Payment Plan.
What happens if I change health or drug plans?
If you leave your current plan, or change to a new Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage), your participation in the Medicare Prescription Payment Plan will end.
Contact your new plan if you’d like to participate in the Medicare Prescription Payment Plan
again.
What programs can help lower my costs?
If you have limited income and resources, find out if you’re eligible for one of these programs:
- Extra Help: A Medicare program that helps pay your Medicare drug costs. Visit ssa.gov/medicare/part-d-extra-help to find out if you qualify and apply. You can also apply with your State Medical Assistance (Medicaid) office. Visit Medicare.gov/ExtraHelp to learn more.
- Medicare Savings Programs: State-run programs that might help pay some or all of your Medicare premiums, deductibles, copayments, and coinsurance. Visit Medicare.gov/medicare-savings-programs to learn more.
- State Pharmaceutical Assistance Programs (SPAPs): Programs that might include coverage for your Medicare drug plan premiums and/or cost sharing. SPAР contributions may count toward your Medicare drug coverage out-of-pocket limit. Visit go.medicare.gov/spap to learn more.
- Manufacturer Pharmaceutical Assistance Programs (sometimes called Patient Assistance Programs (PAPs)): Programs from drug manufacturers to help lower drugs costs for people with Medicare. Visit go.medicare.gov/pap to learn more.
Many people qualify for savings and don’t realize it. Visit Medicare.gov/basics/costs/help, or contact your local Social Security office to learn more. Find your local Social Security office at ssa.gov/locator/.
Where can I get more information?
- Your health or drug plan: Visit your plan’s website, or call your plan to get more information.
- Medicare: Visit Medicare.gov/prescription-payment-plan, or call 1-800-MEDICARE(1-800-633-4227), 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
Examples of how a monthly bill is calculated
Example 1:
You take several high-cost drugs that have a total out-of-pocket cost of $500 each month. In January 2025, you join the Medicare Prescription Payment Plan through your Medicare drug plan or Medicare health plan with drug coverage.
We calculate your first month’s bill in the Medicare Prescription Payment Plan differently than your bill for the rest of the months in the year:
- First, we figure out your “maximum possible payment” for the first month:
| $2,100 [annual out-of-pocket maximum] – $0 [no out-of-pocket costs before using this payment option] = $2,100 ————————— 12 [remaining months in the year] | = $175 [your ‘maximum possible payment’ for the first month] |
- Then, we figure out what you’ll pay for January:
- Compare your total out-of-pocket costs for January ($500) to the “maximum possible payment” we just calculated: $166.67.
- Your plan will bill you the lesser of the two amounts. So, you’ll pay $166.67 for the month of January.
- You have a remaining balance of $333.33 ($500-$166.67).
For February and the rest of the months left in the year, we calculate your payment differently:
| $333.33 [remaining balance] + $500 [new costs] = $833.33 ————————— 11 [remaining months in the year] | = $75.76 [your payment for February] |
We’ll calculate your March payment like we did for February:
| $757.57 [remaining balance] + $500 [new costs] = $1,257.57 ————————— 10 [remaining months in the year] | = $125.76 [your payment for March] |
In April, when you refill your prescriptions again, you’ll reach the annual out-ofpocket maximum for the year ($2,000 in 2025). You’ll continue to pay what you already owe and get your prescription(s), but after April you won’t add any new out-of-pocket costs for the rest of the year.
| $1,131.81 [remaining balance] + $500 [new costs] = $1631.81 ————————— 9 [remaining months in the year] | = $181.31 [your payment for April and all remaining months in the year] |
Even though your payment varies each month, by the end of the year, you’ll never pay more than:
- The total amount you would have paid out-of-pocket.
- The total annual out-of-pocket maximum ($2,000 in 2025).
Remember, this is just your monthly payment for your out-of-pocket drug costs. You still need to pay your health or drug plan’s premium (if you have one) each month.
| Example 1: Start participating in January with high drug costs early in the year | |||
|---|---|---|---|
| Month | Your drug costs (without this payment option) | Your monthly payment (with this payment option) | Notes |
| January | $500 | $166.67 | This is when you started participating in this payment option. Remember, your first month’s bill is based on the “maximum possible payment” calculation. We calculate your bill for the rest of the months in the year differently. |
| February | $500 | $75.76 | |
| March | $500 | $125.76 | |
| April | $500 | $181.31 | This month you reached the annual out-of-pocket maximum ($2,000 in 2025). You’ll have no new out-of-pocket drug costs for the rest of the year. |
| May | $0.00 | $181.31 * | *You’ll still get your $500 drugs each month, but because you’ve reached the annual out-of-pocket maximum, you won’t add any new out-of-pocket costs for the rest of the year. You’ll continue to pay what you already owe. |
| June | $0.00 | $181.31 * | |
| July | $0.00 | $181.31 * | |
| August | $0.00 | $181.31 * | |
| September | $0.00 | $181.31 * | |
| October | $0.00 | $181.31 * | |
| November | $0.00 | $181.31 * | |
| December | $0.00 | $181.31 * | |
| Total | $2,000.00 | $2,000.00 | You’ll pay the same total amount for the year, even if you don’t use this payment option. |
If you’re concerned about paying $500 each month from January to April, this payment option will help you manage your costs. If you prefer to pay $500 each month for 4 months and then pay $0 for the rest of the year, this payment option might not be right for you. Contact your health or drug plan for personalized help.
Example 2:
You take several drugs that have a total out-of-pocket cost of $80 each month. In January 2025, you join the Medicare Prescription Payment Plan through your Medicare drug plan or Medicare health plan with drug coverage.
We calculate your first month’s bill in the Medicare Prescription Payment Plan differently than your bill for the rest of the months in the year:
- First, we figure out your “maximum possible payment” for the first month:
| $2,100 [annual out-of-pocket maximum] – $0 [no out-of-pocket costs before using this payment option] = $2,100 ————————— 12 [remaining months in the year] | = $175 [your ‘maximum possible payment’ for the first month] |
- Then, we figure out what you’ll pay for January:
- Compare your total out-of-pocket costs for January ($80) to the “maximum possible payment” we just calculated: $166.67.
- Your plan will bill you the lesser of the two amounts. So, you’ll pay $80 for the month of January.
- You have a remaining balance of $O.
For February and the rest of the months left in the year, we calculate your payment
differently:
| $O [remaining balance] + $80 [new costs] = $80 ————————— 11 [remaining months in the year] | = $7.27 [your payment for February] |
We’ll calculate your March payment like we did for February:
| $72.73 [remaining balance] + $80 [new costs] = $152.73 ————————— 10 [remaining months in the year] | = $15.27 [your payment for March] |
Even though your payment varies each month, by the end of the year, you’ll never pay more than:
- The total amount you would have paid out-of-pocket.
- The total annual out-of-pocket maximum ($2,000 in 2025).
Remember, this is just your monthly payment for your out-of-pocket drug costs. You still need to pay your health or drug plan’s premium (if you have one) each month.
| Example 1: Start participating in January with high drug costs early in the year | |||
|---|---|---|---|
| Month | Your drug costs (without this payment option) | Your monthly payment (with this payment option) | Notes |
| January | $80.00 | $80.00 | This is when you started using this payment option. Remember, your first month’s bill is based on the “maximum possible payment” calculation. We calculate your bill for the rest of the months in the year differently.Select 64 more words to run Humanizer. |
| February | $80.00 | $7.27 | |
| March | $80.00 | $15.27 | |
| April | $80.00 | $24.16 | |
| May | $80.00 | $34.16 | |
| June | $80.00 | $45.59 | |
| July | $80.00 | $58.93 | |
| August | $80.00 | $74.92 | |
| September | $80.00 | $94.93 | |
| October | $80.00 | $121.59 | |
| November | $80.00 | $161.59 | |
| December | $80.00 | $241.59 | |
| Total | $960.00 | $960.00 | You’ll pay the same total amount for the year, even if you don’t use this payment option. |
Depending on your specific circumstances, you might not benefit from using this payment option due to the higher payments that start in September. Contact your health or drug plan for personalized help.
Example 3:
You pay $4 every month in out-of-pocket costs for a prescription you use regularly. In April 2025, you need a new one-time prescription that costs $613, so your total out-of-pocket costs in April are $617. That same month, before you fill your prescriptions, you decide to participate in the Medicare Prescription Payment Plan through your Medicare drug plan or Medicare health plan with drug coverage.
We calculate your first month’s bill in the Medicare Prescription Payment Plan differently than your bill for the rest of the months in the year:
- First, we figure out your “maximum possible payment” for the first month:
| $2,000 [annual out-of-pocket maximum] $12 [your out-of-pocket costs before using this payment option] = $1,988 ————————— 9 [remaining months in the year] | = $220.89 [your “maximum possible payment” for the first month] |
- Then, we figure out what you’ll pay for April:
- Compare your total out-of-pocket costs for April ($617) to the “maximum possible payment” we just calculated: $220.89.
- Your plan will bill you the lesser of the two amounts. So, you’ll pay $220.89 for the month of April.
- You have a remaining balance of $396.11 ($617 – $220.89).
For May and the rest of the months left in the year, we calculate your payment differently:
| $396.11 [remaining balance] + $4 [new costs] = $400.11 ————————— 8 [remaining months in the year] | = $50.01 [your payment for May] |
Your payments will vary throughout the year. That’s because you’re adding drug
costs during the year, but you have fewer months left in the year to spread your
payments across.
By the end of the year, you’ll never pay more than:
- The total amount you would have paid out-of-pocket.
- The total annual out-of-pocket maximum ($2,000 in 2025).
Remember, this is just your monthly payment for your out-of-pocket drug costs. You still need to pay your health or drug plan’s premium (if you have one) each month.
| Example 1: Start participating in January with high drug costs early in the year | |||
|---|---|---|---|
| Month | Your drug costs (without this payment option) | Your monthly payment (with this payment option) | Notes |
| January | $4.00 | $4.00 * | *You made these payments directly to the pharmacy before you started participating in the Medicare Prescription Payment Plan. |
| February | $4.00 | $4.00 * | |
| March | $4.00 | $4.00 * | |
| April | $617.00 | $220.89 | This is when you started using this payment option. Remember, your first month’s bill is based on the “maximum possible payment” calculation. We calculate your bill for the rest of the months in the year differently. |
| May | $4.00 | $50.01 | |
| June | $4.00 | $50.59 | |
| July | $124.00 | $71.25 | This month, you need a drug that’s $120, in addition to your $4 drug. Following the same formula we used in May, your payments increase because you’re adding drug costs during the year, but you have fewer months left in the year to spread your payments across. |
| August | $4.00 | $72.05 | |
| September | $4.00 | $73.05 | |
| October | $124.00 | $114.39 | This month, you need a drug that’s $120, in addition to your $4 drug. Following the same formula we used in May, your payments increase because you’re adding drug costs during the year, but you have fewer months left in the year to spread your payments across. |
| November | $4.00 | $161.39 | |
| December | $4.00 | $120.38 | |
| Total | $901.00 | $901.00 | You’ll pay the same total amount for the year, even if you don’t use this payment option. |
If you’re concerned about paying $617 in April, this payment option will help you spread your costs across monthly payments that vary throughout the year. If you’re concerned about higher payments later in the year, this payment option might not be right for you. Contact your health or drug plan for personalized help.
