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Medicare

Medicare prescription drug coverage details

Learn how to use your Part D prescription drug coverage, from understanding the coverage stages, to drug tiers and what you pay.

2025 Drug benefit stages

There are 3 drug payment stages. How much you pay depends on what stage you're in when you get a prescription filled or refilled.

Yearly deductible stage

If your plan has a deductible, you’ll pay the full, negotiated price of your drugs until you’ve reached the deductible amount. Your deductible does not apply to covered insulin products and most adult Part D vaccines.

Initial coverage stage

The plan pays its share of the cost of your covered prescription drugs, and you pay your share until your out-of-pocket drug costs reach $2,000.

Catastrophic coverage stage

The plan will pay the full cost of your drugs.

Track your drug spending

Our plan keeps track of the costs of your prescription drugs and the payments you have made. This way, we can tell you when you have moved from one coverage stage to the next. We share that information each month in your Part D Explanation of Benefits (EOB).

The EOB includes information for that month, totals for the year since January 1, drug price information, and lower-cost prescription options.

View a sample Part D EOB (PDF) to see how your monthly prescription drug spending is tracked and detailed.

Drug tiers

The prescription drugs we cover are grouped in tiers. You’ll see some drugs listed in more than one tier; this may be because the drug is available in both a generic and brand-name version. Plans may have different drug tiers.

You can learn more about tiers and your plan's approved drug list in your Formulary Guide and Evidence of Coverage documents.

Other drug information