Pay BillPart D Prescription Drug Coverage
Prescription drug coverage is an important part of your Medicare Advantage plan. Knowing how it works can help you manage costs. For complete details about your Part D coverage, refer to your plan’s Evidence of Coverage.
Coverage Stages
Deductible Stage
At the beginning of the plan year, you pay out of pocket for your Part D prescription drugs until you reach your Prescription Deductible. Not all plans will have a Prescription Deductible.
Initial Coverage Stage
Once you’ve reached your Part D deductible, you move to the Initial Coverage Stage. If your plan does not have a Prescription Deductible, you will start the plan year in the Initial Coverage Stage.
In this stage, you pay your tier copay/coinsurance for your Part D drugs. Deductibles and tier copay/coinsurance amounts vary by plan. You will be in the Initial Coverage Stage until you reach your annual out-of-pocket maximum. ($2,000 in 2025 / $2,100 in 2026)
Catastrophic Stage
Once you have spent the annual out-of-pocket maximum on your Part D drugs in a calendar year, you move to the Catastrophic Coverage Stage. You will not pay out of pocket for Part D drugs in this stage, and you will stay in this stage until the end of the calendar year.
Need Help Paying for Drug Costs?
You may be able to save on your prescription drug costs through EPIC, Low Income Subsidy (LIS) or Extra Help. To find out if you are eligible, speak to a RedShirt.®
Medicare Prescription Payment Plan
Medicare offers a payment plan program for any member who wants help managing monthly Part D drug costs. Find out if the Medicare Prescription Payment Plan is right for you.
Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO, HMO-SNP, HMO-POS and PPO plans. Enrollment in Independent Health depends on contract renewal.
Refer to your plan's Evidence of Coverage and your plan's formulary, or list of covered drugs, for more details about your Part D benefit and your drug costs. Beneficiaries must use network pharmacies to access their prescription drug benefit, unless a network pharmacy cannot be accessed. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. Limitations, copayments and restrictions may apply. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
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Last Updated 10/1/2025