Part D Medicare 2024

Here are the highlights for the CMS defined Standard Benefit Plan for 2024. The "Standard Benefit Plan" is the minimum allowable plan to be offered.

Cost Sharing may change depending on the pharmacy you choose and when you enter a new phase of the Part D Medicare benefit.

Initial Deductible: $545 The amount you pay before a plan covers your prescription drug costs.

Initial Coverage Limit: $5,030

During this stage, the plan pays its share of the cost and you pay your share. You are in this stage until your payments and the plan's payments total $5,030 for the year.

Coverage Gap ("donut hole")

When your drug costs and plan payment for the year reach $5,030, you enter the Coverage Gap Stage (donut hole). You will pay 25% of the cost for formulary brand-name and generic drugs. You will stay in this stage until your out-of-pocket costs for the year reach $8,000.

Catastrophic Coverage After your out-of-pocket costs for prescription drugs reach $8,000, you pay $0 for plan covered Part D and Excluded drugs.

Part D Medicare Income-Related Monthly Adjustment Amounts

Beneficiaries who file individual tax returns with modified adjusted gross income:	Beneficiaries who file joint tax returns with modified adjusted gross income:	Income-related monthly adjustment amount
Less than or equal to $103,000	Less than or equal to $206,000	$0.00
Greater than $103,000 and less than or equal to $129,000	Greater than $206,000 and less than or equal to $258,000	$12.90
Greater than $129,000 and less than or equal to $161,000	Greater than $258,000 and less than or equal to $322,000	$33.30
Greater than $161,000 and less than or equal to $193,000	Greater than $322,000 and less than or equal to $386,000	$53.80
Greater than $193,000 and less than $500,000	Greater than $386,000 and less than $750,000	$74.20
Greater than or equal to $500,000	Greater than or equal to $750,000	$81.00

Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year but file a separate return, are as follows:

Beneficiaries who are married and lived with their spouses at any time during the year, but file separate tax returns from their spouses with modified adjusted gross income:	Income-related monthly adjustment amount
Less than or equal to $103,000	$0.00
Greater than $103,000 and less than $397,000	$74.20
Greater than or equal to $397,000	$81.00