Copayment/coinsurance in drug plans

These are the amounts you pay for your covered drugs after the 

Deductible [glossary]

 (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 throughout the year due to changes in the drug’s total cost. The amount you pay will also depend on the 

Tiers

 level assigned to your drug.


Once you and your plan spend $4,130 combined on drugs (including deductible), you’ll pay no more than 25% of the cost for prescription drugs until your out-of-pocket spending is $6,550, under the standard drug benefit.

 

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.