These are the amounts you pay for your covered drugs after the deductible (if the plan has one). You pay your share and your plan pays its share for covered drugs. If you pay coinsurance, these amounts may vary because drug plans and manufacturers can change what they charge at any time throughout the year. The amount you pay will also depend on the tier level assigned to your drug.
Your plan may raise the copayment or coinsurance you pay for a particular drug when the manufacturer raises their price, or when a plan starts to offer a generic form of a drug, but you keep taking the brand name drug.
Here’s a video about how drug costs can differ by pharmacy.
Under the standard drug benefit, once you and your plan spend $5,030 combined on drugs (including deductible) in 2024, you’ll pay no more than 25% of the cost for prescription drugs until your out-of-pocket spending (including certain payments made on your behalf, like through the Extra Help program) is $8,000.