Those with partial Extra Help will pay $4.15 for generic drugs and $10.35 for brand-name drugs for the remainder of the calendar year. ![]() Those with full Extra Help who reach catastrophic coverage generally will pay nothing for covered drugs for the remainder of the calendar year. Your out-of-pocket costs also change when you reach catastrophic coverage ($7,400 out of pocket in 2023). S had partial Extra Help, he would pay a 15% coinsurance for his prescription drugs or his plan’s standard copay. S would pay the Extra Help copay throughout the year. S had full Extra Help and a monthly income below $1,153, his copays would be $1.45 for generics and $4.30 for brand-name drugs, making his generic Extra Help copay less costly than the plan copay of $2.00. S will therefore pay the plan copay of $2.00 because it is cheaper than the Extra Help copay of $4.15. This notice informs people with Medicare who continue to automatically qualify for Extra Help for the following year that their copayment level will change. However, his plan copay for his generics is $2.00. ![]() S has full Extra Help and a monthly income above $1,153, so his Extra Help copays are $4.15 for generics and $10.35 for brand-name drugs. Note that plan copays for prescriptions may change during the year, meaning at times the price for your prescription drugs may differ.Įxample: Mr. You always pay the lower cost between the two. If you have Extra Help, throughout the year you will pay either the Extra Help copayment or your plan’s copay for your prescription drugs.
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