Inpatient Hospital Care Nursing/Hospice Care Exams Outpatient Visits Lab Tests/Imaging Surgery Medical Equipment Wellness Services Routine Vision Routine Hearing Prescription Drugs Hospital Care Deductible (Part A)
Inpatient Hospital Care Nursing/Hospice Care Exams Outpatient Visits Lab Tests/Imaging Surgery Medical Equipment Wellness Services Routine Vision Routine Hearing Prescription Drugs Tests & Surgery Deductible
Inpatient Hospital Care Nursing/Hospice Care Exams Outpatient Visits Lab Tests/Imaging Surgery Medical Equipment Wellness Services Routine Vision Routine Hearing Prescription Drugs Hospital Care Deductible (Part A) Tests & Surgery Deductible (Part B)
Deductible: The amount you pay before a plan covers your prescription drug costs, if applicable.
Initial Coverage: The plan pays its share of the cost, and you pay your share. This stage lasts until your payments and the plan’s payments total $4,660 for the year.
Coverage Gap: Begins when your drug costs and plan payments for the year reach $4,660. You will pay 25% of the cost for covered generic and brand-name drugs until your out-of-pocket costs for the year reach $7,400.
Catastrophic Coverage: If your out-of-pocket costs for prescription drugs reach $7,400, you will pay either 5% of the cost of the drug, a co-pay of $4.15 for generic drugs, or a co-pay of $10.35 for all other drugs, whichever is greater.
ALL INFORMATION ARE NOT ADVICE AND NOT UPDATED PLEASE TALK TO AGENT
