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Standard Medicare Prescription Drug Benefit, 2013. CATASTROPHIC COVERAGE. Catastrophic Coverage Limit = $6,733.75* in Estimated Total Drug Costs. Enrollee pays 5%. Plan pays 15 %; Medicare pays 80%. Brand-name drugs Enrollee pays 47.5%; Plan pays 2.5% 50% manufacturer discount
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Standard Medicare Prescription Drug Benefit, 2013 CATASTROPHIC COVERAGE CatastrophicCoverage Limit = $6,733.75* in Estimated Total Drug Costs Enrolleepays 5% Plan pays 15%; Medicare pays 80% Brand-name drugsEnrollee pays 47.5%; Plan pays 2.5%50% manufacturer discount Generic drugs Enrollee pays 79%; Plan pays 21% COVERAGE GAP Initial Coverage Limit = $2,970 in Total Drug Costs Enrollee pays 25% INITIAL COVERAGE PERIOD Plan pays 75% Deductible = $325 DEDUCTIBLE NOTE: *Amount corresponds to the estimated catastrophic coverage limit for non-LIS enrollees ($6,734 for LIS enrollees), which corresponds to TrOOP spending of $4,750.SOURCE: Kaiser Family Foundation illustration based on CMS standard benefit parameter update for 2013. Amounts rounded to nearest dollar.
