How does it work?
In 2023 the annual deductible is $505, from there you enter into the “Initial Coverage Limit”, and that is $4,660. While at this level you pay co-payments for your medication based on the formulary level, or tier, for that plan. If you go over this limit you enter into the next level which is a “Coverage Gap”. While at this level of coverage you will pay 25% of the cost of your medications until you reach $7,400 in medication. From this point on, for the rest of the year, you are in the “Catastrophic Coverage” level. You only pay 5% or $10.35 for Brand name drugs, and 5% or $4.15 of generics, which ever is greater. When calculating these drug limits the full cost of the drug you are receiving is considered, not what you actually pay.
Things that can affect the price of your plan.
- Late Penalty – If you go without creditable drug coverage you will pay 1% of teh national average ($32.74 in 2023) for every full month you went without coverage. This penalty is for the rest of your life unless you qualify for Extra Help or Medicaid at some point, at which point they will waive the cost to the state.
- IRMAA – “Income related monthly adjusted amount” This amount is calculated using your income tax information from 2 years ago. So, for 2023, your tax information from 2021 will be assessed. The Chart below shows the limits and how they will effect your montly cost.
We are a full service Life/Health/Retirment Planning agency located in Lafayette Indiana, although we are licensed to do business in Illinios, Michigan, and Texas as well. We strive to have one of the largest portfolios available to independant agencies like ours so that we can always offer our clients the best value for thier hard earned money.