Copayment/coinsurance in drug plans

After you pay your plan's 

Deductible [glossary]

 (if your plan has one), the amount you pay for each prescription is either:

  • A Copayment . With a copayment, you pay a set amount (like $10) for all drugs on a tier. You may pay a lower copayment for generic drugs than brand-name drugs.
  • Coinsurance . With coinsurance, you pay a percentage of the cost (like 25%) of the drug.

Some Medicare Prescription Drug Plans have levels or "

Tiers

" of copayments/coinsurance, with different costs for different types of drugs.

Note

The amount you pay for a covered prescription is usually for a one-month supply of a drug. However, you can request less than a one-month supply. You might do this if you’re trying a new medication or you want to synchronize refills for your medications.

If you get less than a one-month supply, the amount you pay is reduced based on the amount you actually get. Talk with your prescriber to get a prescription for less than a one-month supply.