Anabelle Paghiligan-Wall, Medicare Insurance Broker
About Me
Licensed Insurance Agent
Q&A with Anabelle Paghiligan-Wall
I'm confused about the different tiers in Medicare Part D plans. How do they affect what I pay for my medications?
Answer: Hi. Tier 1 has lowest copayment. Mostly generic drugs. Tier 2 has medium copayment. Mostly generic too. Tier 3 has higher copayment, non-prefereed brand name drugs, specialty toer has the highest copayment, very high priced medications. Also for 2026, drug plans have 3 stages: Deductble stage ( $615), Initial stage coverage stage after you reached the $615 deductible , you will pay 25% of the coast of coinsurance drugs until out of pocket cost reached $2100(2026) after that you will be in Catastrophic stage wherein you do not have to pay out of pocket for covered part D for the rest of the year. But of course, it depends on what type plan do you have. This is the general information of tiers and drug coverage stages. Thank you.
