1

Christopher E. O’Brien 2015 Medicare Part D - Standard Benefit Design Parameters $320 deductible 25% coinsurance 100% coinsurance (“Donut Hole”) $320.00 $2,960.00 $6,680.00 $0.00 Member Responsibility Part D Covered Out-of-Pocket threshold: $4,700 ($320 + $660 + $3,720) Brand Name Drug Discount: 52.5% Catastrophic Coverage: Max of: 5% copay or $2.65 gen. / $6.60 br. Source: http://www.q1medicare.com/PartD-The-2015-Medicare-Part-D-Outlook.php up to $320 25% up to $660 100% up to $3,720 Max of 5% or $2.65 / $6.60 per

2015 Medicare Part D - Standard Benefit Design Parameters

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Page 1: 2015 Medicare Part D - Standard Benefit Design Parameters

Christopher E. O’Brien 2015 Medicare Part D - Standard Benefit Design Parameters

$320 d

ed

uctib

le

25%

co

insura

nce

100

% c

oin

sura

nce

(“D

onu

t H

ole

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$3

20

.00

$2

,96

0.0

0

$6

,68

0.0

0

$0.0

0

Member Responsibility

Part D Covered

Out-of-Pocket threshold: $4,700 ($320 + $660 + $3,720)

Brand Name Drug Discount: 52.5%

Ca

tastr

oph

ic C

ove

rag

e:

Ma

x o

f: 5

% c

opa

y o

r

$2.6

5 g

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. / $

6.6

0 b

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Source: http://www.q1medicare.com/PartD-The-2015-Medicare-Part-D-Outlook.php

up to

$320 25% up to $660 100% up to $3,720 Max of 5% or $2.65 / $6.60 per

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