These are the amounts you pay for your covered drugs after the
(if the plan has one). You pay your share and your plan pays its share for covered drugs. If you pay
, these amounts may vary throughout the year due to changes in the drug’s total cost. The amount you pay will also depend on the
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.
Once you and your plan spend $4,130 combined on drugs (including deductible) in 2021 ($4,430 in 2022), you’ll pay no more than 25% of the cost for prescription drugs until your out-of-pocket spending is $6,550 in 2021 ($7,050 in 2022) under the standard drug benefit.