Aetna silverscript plus formulary 2024

SilverScript Plus (PDP) S5601 - 061 - 0. (3 / 5) SilverScript Plus (PDP) is a Medicare Part D Prescription Drug Plan by Aetna Medicare. Premium: $89.40. Enroll Now. This page features plan details for 2024 SilverScript Plus (PDP) S5601 – 061 – 0. IMPORTANT: This page has been updated with plan and premium data for 2024.

The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Standard Control Choice Plan. There are upcoming changes to your plan’s drug coverage — and we want to be sure you’re ready. Starting January 1, 2024, you’ll see changes to the drugs your Aetna Standard Plan covers. It’s important that you review the changes in the chart enclosed. Talk to your doctor about how these changes might impact you. The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Aetna Standard Plan. Generic multivitamins (except Activite, Dexifol, Folvite-D, Genicin Vita-S, HylaVite, Multipro, TronVite, Vitasure) are the only preferred options. Generic prenatal vitamins are the only preferred options. QVAR REDIHALER and fluticasone HFA are covered for members 6 years of age and under. This document contains references to brand-name ...Use our search tool to see if your drugs are covered and if any lower-cost generic equivalents are available. Start with your ZIP code. Add your drug names and doses. Then, select a plan to find network pharmacies and estimate your drug prices. ZIP CODE. Search 2024 drug list. Medicare Advantage members, you can request a copy of your 2024 Evidence of Coverage or Formulary if you need one. Prescription drug plan members (SilverScript® Choice (PDP), SilverScript Plus (PDP), or SilverScript SmartSaver (PDP)), you can request a copy of your Evidence of Coverage, formulary and pharmacy directory.

You can attend the Paris Olympic opening and closing ceremonies for free. Events start at $26. While it might be too early to look for flights, it’s the right time to buy tickets f...In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products. Pharmacy benefits are administered by an affiliated pharmacy benefit manager, CVS Caremark. Aetna is part of the CVS Health family of companies. Please remember that this is not a complete list of ...Plan features and availability may vary by service area. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 10 days. You can call 1-866-235-5660 (TTY: 711), 24 hours a day, 7 days a week if you do not receive your mail-order drugs within ...We’ve got answers. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Texas to help cover your prescription drug costs.N63 Aetna Direct Plan - Self Plus One N62 Aetna Direct Plan - Self and Family ... 2024 Aetna HealthFund® HDHP and Aetna Direct Plan 2 Table of Contents . ... For instance, “you” means the enrollee and each covered family member, "we" means Aetna.

Table of Contents: What is SilverScript? SilverScript Additional Benefits. Who Owns SilverScript? Is SilverScript Part of Aetna? Aetna SilverScript …An Aetna Medicare formulary typically lists drugs grouped by the types of medical conditions they are used to treat. It also lists them in alphabetical order. To find out which drugs are covered by Aetna Medicare plans in your area, you can speak with a licensed insurance agent. You can reach one by calling 1-877-890-1409 TTY Users: 711.Aetna Medicare Silverscript Login Medicare Login HQ, Prescription drug plan members (silverscript® choice (pdp), silverscript plus (pdp), or silverscript smartsaver (pdp)), you can request a copy of your evidence of coverage,. A formulary is a list of covered drugs selected by silverscript in consultation with a team of health care providers ...Feb 8, 2024 · We’ve got answers. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in New York to help cover your prescription drug costs. Want a full list of every drug covered by your plan? Download the formulary and find other important prescription drug information. Check the tier a drug is on, any limits or requirements and mail order availability. Generally, the lower the tier, the less you pay. Complete the steps below to get a full list of all covered drugs. Disney Cruises 2024 includes trips on the Disney Wish, Disney Fantasy and more to the Caribbean, Mexico, Castaway Cay and more. Save money, experience more. Check out our destinati...

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This is a list of drugs that members can get in Aetna Better Health Premier Plan. Aetna Better Health Premier Plan is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. The formulary may change at any time. You will receive notice when necessary.Ron DeSantis's decision to forgo traditional venues in favor of making a big media moment with Musk marks a new phase for the social network. Florida Governor Ron DeSantis made the...The SilverScript Choice plan offers average premiums of $49 per month and a $2 copayment for Tier 1 medications. The SilverScript Choice plan accounted for the greatest share of 2023 enrollment among Part D plans that were offered nationwide. More than 16% of Part D beneficiaries in the country were enrolled in the SilverScript Choice plan. 1.The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Standard Control Choice Plan.This formulary was updated on 05/01/2024. For more recent information or other questions, please contact Aetna® Medicare Member Services at 1-855-463-0933 or for …

Review our Medicare Supplement Insurance plans. 87% of Aetna® Medicare Advantage members are in 4-star plans or higher for 2024. Every year, Medicare evaluates plans based on a 5-star rating system. Read the latest press release on our Star Ratings for 2024 and our ongoing commitment to improving health outcomes for members.SilverScript Choice (PDP) will be available to members with full Extra Help for a $0 monthly plan premium in 21 states and D.C., while SilverScript Plus (PDP) has the most robust prescription drug ...SilverScript Plus offers monthly premiums that average $103 per month, but the plan includes a $0 copayment for drugs in Tier 1. ... SilverScript Medicare Part D plans use the Aetna Medicare drug formulary, which is a list of drugs covered by the plan. Drugs are separated into different tiers, with common generic drugs typically being in Tier 1 ... 2024 Medicare Part D Plan Formulary Information. SilverScript Plus (PDP) (S5601-003-0) Benefits & Contact Info. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Call drug plan for more details. The SilverScript Plus (PDP) (S5601-003-0) Formulary Drugs Starting with the Letter A. Cost of 90-day supply of prescription medication*. Tier 1: $6. Additional gap coverage. No. SilverScript® Plus (PDP) Average monthly premium (Your actual premium may differ) $103.51. Deductible. $0 For Tiers 1 & 2.OMB Approval 0938-1051 (Expires: February 29, 2024) GRP_EOC_2024_D2_AE_ESA_MAPD January 1 – December 31, 2024 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Aetna Medicare Plan (PPO) This document gives you the details about your Medicare health care and prescription drug coverage*FOR SILVERSCRIPT PLUS TIER 1/TIER 2 90-DAY SUPPLY: Pay a $0 copay for up to a 90-day supply of Tier 1 and Tier 2 drugs, at preferred retail pharmacies or by standard mail-order delivery. ... Y0001_34893_2024_M. You are leaving AetnaMedicare.com for InstaMed.com. ... Caremark.com is the secure website where … There are upcoming changes to your plan’s drug coverage — and we want to be sure you’re ready. Starting January 1, 2024, you’ll see changes to the drugs your Aetna Standard Plan covers. It’s important that you review the changes in the chart enclosed. Talk to your doctor about how these changes might impact you. After the total drug costs paid by you and the plan reach $5,030, up to the out-of-pocket threshold of $6,350. For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.Use our search tool to see if your drugs are covered and if any lower-cost generic equivalents are available. Start with your ZIP code. ... Y0001_34893_2024_M. You are leaving AetnaMedicare.com for InstaMed.com. ... Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for …

Total Number of Formulary Drugs: 3,643 drugs: Browse the SilverScript SmartSaver (PDP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy ...

Total Number of Formulary Drugs: 3,638 drugs: Browse the SilverScript Plus (PDP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost ...Use our search tool to see if your drugs are covered and if any lower-cost generic equivalents are available. Start with your ZIP code. ... Y0001_34893_2024_M. You are leaving AetnaMedicare.com for InstaMed.com. ... Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for …Generic multivitamins (except Activite, Dexifol, Folvite-D, Genicin Vita-S, HylaVite, Multipro, TronVite, Vitasure) are the only preferred options. Generic prenatal vitamins are the only preferred options. QVAR REDIHALER and fluticasone HFA are covered for members 6 years of age and under. This document contains references to brand-name ...Total Number of Formulary Drugs: 3,643 drugs: Browse the SilverScript SmartSaver (PDP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy ... SilverScript Employer PDP sponsored by State of Maryland (SilverScript) 2024 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/17/2023. For more recent information or other questions, please There are upcoming changes to your plan’s drug coverage — and we want to be sure you’re ready. Starting January 1, 2024, you’ll see changes to the drugs your Aetna Standard Plan covers. It’s important that you review the changes in the chart enclosed. Talk to your doctor about how these changes might impact you.The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Advanced Control Plan - Aetna.Feb 8, 2024 · SilverScript ® Plus (PDP) Average Monthly Premium. (Your actual premium may differ) $11.19. $46.59. $103.51. Deductible. $0. For Tier 1. Table of Contents: What is SilverScript? SilverScript Additional Benefits. Who Owns SilverScript? Is SilverScript Part of Aetna? Aetna SilverScript …

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If you decide to opt out of the SilverScript PDP, you will automatically remain in your current NALC prescription plan. If you need more information or wish to opt out, please call SilverScript at 833-272-9886, 24 hours a day, 7 days a week. Health Equity. NALC-MRA Claim Form | NALC-MRA Claim Form Instructions*FOR SILVERSCRIPT PLUS TIER 1/TIER 2 90-DAY SUPPLY: Pay a $0 copay for up to a 90-day supply of Tier 1 and Tier 2 drugs, at preferred retail pharmacies or by standard mail-order delivery. ... Y0001_34893_2024_M. You are leaving AetnaMedicare.com for InstaMed.com. ... Caremark.com is the secure website where Aetna Medicare …The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Aetna Health Exchange Individual Plan.2024 Medicare Part D Plan Formulary Information. SilverScript SmartSaver (PDP) (S5601-178-0) Benefits & Contact Info. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Call drug plan for more details. The SilverScript SmartSaver (PDP) (S5601-178-0) Formulary Drugs Starting with the Letter A. Want a full list of every drug covered by your plan? Download the formulary and find other important prescription drug information. Check the tier a drug is on, any limits or requirements and mail order availability. Generally, the lower the tier, the less you pay. Complete the steps below to get a full list of all covered drugs. Enroll in premium Part D coverage with no deductible Members of SilverScript®Plus (PDP) from Aetna® Medicare enjoy the peace of mind of comprehensive prescription drug coverage with $0 deductible, no “donut hole” or gap in coverage, and $0 copays on 90-day supplies of Tier 1 and 2 drugs at preferred pharmacies.. Enter your ZIP code to find out …Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Pennsylvania to help cover your prescription drug costs.SilverScript Plus (PDP) S5601 - 061 - 0. (3 / 5) SilverScript Plus (PDP) is a Medicare Part D Prescription Drug Plan by Aetna Medicare. Premium: $89.40. Enroll Now. This page features plan details for 2024 SilverScript Plus (PDP) S5601 – 061 – 0. IMPORTANT: This page has been updated with plan and premium data for 2024.The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Aetna Health Exchange Individual Plan.Members with Aetna Medicare SilverScript prescription drug plans can log in or register for an account below. Through your secure, personal account at Caremark.com, you can view and manage prescriptions, including mail order delivery, and review your Explanation of Benefits (EOB). ... Y0001_34893_2024_M. You are leaving AetnaMedicare.com for ... ….

The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Advanced Control Choice Plan.We would like to show you a description here but the site won’t allow us.Total Number of Formulary Drugs: 3,593 drugs: Browse the SilverScript Plus (PDP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost ...We would like to show you a description here but the site won’t allow us.Oct 1, 2022 ... Aetna made major changes to our formularies (drug ... SilverScript is a Prescription Drug Plan with a Medicare contract marketed through Aetna ...Disney Cruises 2024 includes trips on the Disney Wish, Disney Fantasy and more to the Caribbean, Mexico, Castaway Cay and more. Save money, experience more. Check out our destinati...Provide all supporting clinical information for. PA and UM requirements as well as Tier Exception requirements, if applicable. Additionally, non-formulary and ... This formulary is current as of January 1, 2024. To get updated information about the drugs covered by our plan, please contact us at the number on your member ID card. 2024 Aetna Specialty Drug List 1011950-01-09 (4/24) How to use this guide You may fill these drugs at an in -network specialty pharmacy. Look up your plan documents for specialty drug coverage details. You’ll also learn more about the requirements and limitations of your pharmacy Aetna silverscript plus formulary 2024, ©2024 Aetna Inc. For language services, please ... Applies to: Aetna Choice® POS, Aetna Choice POS II ... Plus networks. Not all plans are offered in all ..., You can attend the Paris Olympic opening and closing ceremonies for free. Events start at $26. While it might be too early to look for flights, it’s the right time to buy tickets f..., OMB Approval 0938-1051 (Expires: February 29, 2024) GRP_EOC_2024_D2_AE_ESA_MAPD January 1 – December 31, 2024 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Aetna Medicare Plan (PPO) This document gives you the details about your Medicare health care and prescription drug coverage, SilverScript Choice: $545 deductible for all tiers; SilverScript Plus: $0 deductible for tiers 1 and 2; 2024 premiums. Premiums for SilverScript plans can start as low as $0 if you qualify for ..., The Conrad Bora Bora Nui is a favorite among award travelers. Right now, you can book it with wide-open award space in early 2024. Editors note: This post was updated with new info..., SilverScript Choice (PDP) will be available to members with full Extra Help for a $0 monthly plan premium in 21 states and D.C., while SilverScript Plus (PDP) has the most robust prescription drug ..., This formulary was updated on 05/01/2024. For more recent information or other questions, please contact Aetna® Medicare Member Services at 1-855-463-0933 or for TTY users: 711, 8 a.m. to 8 p.m., E.S.T., 7 days a week, or visit AetnaBetterHealth.com/Virginia-hmosnp/formulary Note to existing members: This formulary has changed since last year ..., OMB Approval 0938-1051 (Expires: February 29, 2024) GRP_EOC_2024_D2_AE_ESA_MAPD January 1 – December 31, 2024 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Aetna Medicare Plan (PPO) This document gives you the details about …, 2022 Medicare Part D Plan Formulary Information. SilverScript Plus (PDP) (S5601-107-0) Benefit Details. This plan covers select insulin pay $35 copay. See individual insulin cost-sharing below. The SilverScript Plus (PDP) (S5601-107-0) Formulary Drugs Starting with the Letter A. in CMS PDP Region 19 which includes: AR., Apr 15, 2024 · Want a full list of every drug covered by your plan? Download the formulary and find other important prescription drug information. Check the tier a drug is on, any limits or requirements and mail order availability. Generally, the lower the tier, the less you pay. Complete the steps below to get a full list of all covered drugs. , After the total drug costs paid by you and the plan reach $5,030, up to the out-of-pocket threshold of $6,350. For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. , Changes beginning July 1, 2024. On or after this date, log in to your member website. Here, you can search for and estimate the cost of your drug(s). You can also find options that …, Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in New Jersey to help cover your prescription drug costs., Frequently Asked Questions About 2024 Health Care Coverage Watch your mail for information from Aetna and SilverScript or CVS Caremark. For additional information, refer to your STRS Ohio open-enrollment materials available in late October. 2024 MEDICAL COVERAGE Aetna Medicare Plan: 833-383-4612 (toll-free); strs.aetnamedicare.com …, SilverScript Plus (PDP) S5601 - 013 - 0. (3 / 5) SilverScript Plus (PDP) is a Medicare Part D Prescription Drug Plan by Aetna Medicare. Premium: $99.60. Enroll Now. This page features plan details for 2024 SilverScript Plus (PDP) S5601 – 013 – 0. IMPORTANT: This page has been updated with plan and premium data for 2024., An Aetna Medicare formulary typically lists drugs grouped by the types of medical conditions they are used to treat. It also lists them in alphabetical order. To find out which drugs are covered by Aetna Medicare plans in your area, you can speak with a licensed insurance agent. You can reach one by calling 1-877-890-1409 TTY Users: 711., That’s why almost 75 percent of people who are on Medicare — or more than 47 million people 2 — are enrolled in a plan with prescription drug coverage. Forty-one percent of those over 65 take five or more medications a day. 1. As you figure out the best plan for your needs, here’s what you need to know about prescription drug coverage., Aetna Medicare SilverScript SmartSaver (PDP) S5601 192 $9.90 $280.00 EA No 3 Blue Cross and Blue Shield of Illinois Blue Cross MedicareRx Basic (PDP) S5715 012 $73.60 $545.00 AE No 3.5, Hospice Formulary List 2024 Candi Corissa, A formulary, also called a “drug list”, shows the prescription drugs that are covered by a particular part d plan. Silverscript plus …, After the total drug costs paid by you and the plan reach $5,030, up to the out-of-pocket threshold of $6,350. For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs., Below are the SilverScript plan formularies for 2024. 2024 SilverScript Choice Part D plan formulary 2024 SilverScript Plus plan formulary ; 2024 SilverScript SmartSaver plan formulary ; What Does Aetna SilverScript Cover? Aetna SilverScript Rx plans cover prescription drugs that include everything from generic and commonly prescribed ..., Total Number of Formulary Drugs: 3,643 drugs: Browse the SilverScript SmartSaver (PDP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy ..., Jan 1, 2024 · What to do if your drugs are changing. Talk to your doctor to find out if changing to a preferred drug is right for you. If they agree, have them send a new prescription to your pharmacy so it’s ready for you to fill January 1, 2024. Your doctor may decide it’s best for you to stay on your current drug. If so, they can ask for medical ... , The Conrad Bora Bora Nui is a favorite among award travelers. Right now, you can book it with wide-open award space in early 2024. Editors note: This post was updated with new info..., Find out if your prescription drug is covered by your 2024 Aetna Standard Plan., Jan 1, 2024 · Non-formulary drug (Other NDCs covered) EPIPEN-JR 2-PAK : Non-formulary; not covered. Covered options include: epinephrine (except Mylan and Teva brands), Auvi -Q . EVOTAZ Moving to non-preferred brand tier EYLEA : Non-formulary; not covered. Covered options include: Byooviz, Cimerli . fluticasone propionate / salmeterol Quantity limits apply. , The SilverScript SmartSaver (PDP) plan offers the right balance between low monthly premiums and the flexible coverage you need. $5.92 national average monthly plan premium *. $0 annual deductible on Tier 1 drugs. $6 copays for a 90-day supply of Tier 1 drugs at preferred pharmacies** or by mail delivery***., We’ve got answers. Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Tennessee to help cover your prescription drug costs., Total Number of Formulary Drugs: 3,638 drugs: Browse the SilverScript Plus (PDP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost ..., An Aetna Medicare formulary typically lists drugs grouped by the types of medical conditions they are used to treat. It also lists them in alphabetical order. To find out which drugs are covered by Aetna Medicare plans in your area, you can speak with a licensed insurance agent. You can reach one by calling 1-877-890-1409 TTY Users: 711., SilverScript Employer PDP sponsored by STRS Ohio (SilverScript) 2024 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 01/29/2024. For more recent information or other questions, please contact Customer Care at 1-800-756-6859, 24 hours a day, 7 ..., SilverScript Plus (PDP) S5601 - 061 - 0. (3 / 5) SilverScript Plus (PDP) is a Medicare Part D Prescription Drug Plan by Aetna Medicare. Premium: $89.40. Enroll Now. This page features plan details for 2024 SilverScript Plus (PDP) S5601 – 061 – 0. IMPORTANT: This page has been updated with plan and premium data for 2024., The coverage gap phase (donut hole) —This begins after your total drug costs for covered prescription drugs reaches the initial coverage limit amount (up to $5,030 in 2024). In this phase, you’ll pay no more than 25% of the cost for covered brand or generic prescription drugs.