How Do Part D Stages Work?


Stage 1 – Deductible 

This is the amount you must pay for your brand-name and generic drugs before your plan starts paying. You will pay the full amount for your drugs until the deductible is reached. 

Remember: Select Health Medicare plans do not have a deductible for Tier 1 and 2 drugs. Coverage for these drugs starts in Stage 2. That means you will only have to pay your deductible for Tier 3, 4, and 5 drugs.

 


Stage 2 – Initial Coverage​

During this stage, you pay your copay, and we pay the rest. You stay in this stage until the amount of your year-to-date total drug costs reach the yearly amount set by Medicare. For 2025, you stay in this stage until the amount you pay for prescriptions reaches $2,000.

 

Stage 3 – Catastrophic Coverage

During this stage, the plan pays the full cost for your covered drugs. You stay in this stage for the rest of the calendar year through December 31.