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Christopher E. O’Brien 2016 Medicare Part D - Standard Benefit Design Parameters 100% up to $3,752 $360 deductible 25% coinsurance 100% coinsurance (“Donut Hole”) $360.00 $3,310.00 $7,062.50 $0.00 Member Responsibility Part D Covered Out-of-Pocket threshold: $4,849.50 ($360 + $737.50 + $3,752) Brand Name Drug Discount: 58% 25% up to $737.50 Catastrophic Coverage: Max of: 5% copay or $2.95 gen. / $7.40 br. Source: http://www.q1medicare.com/PartD-The-MedicarePartDOutlookAllYears.php 100% up to $360 Max of 5% or $2.95 / $7.40 per

2016 Medicare Part D - Standard Benefit Design Parameters

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Page 1: 2016 Medicare Part D - Standard Benefit Design Parameters

Christopher E. O’Brien 2016 Medicare Part D - Standard Benefit Design Parameters

100% up to $3,752

$360 d

ed

uctib

le

25%

co

insura

nce

100

% c

oin

sura

nce

(“D

onu

t H

ole

”)

$3

60

.00

$3,3

10

.00

$7,0

62

.50

$0.0

0

Member Responsibility

Part D Covered

Out-of-Pocket threshold: $4,849.50 ($360 + $737.50 + $3,752) Brand Name Drug Discount: 58%

25% up to $737.50

Ca

tastr

oph

ic C

ove

rag

e:

Ma

x o

f: 5

% c

opa

y o

r

$2.9

5 g

en. / $

7.4

0 b

r.

Source: http://www.q1medicare.com/PartD-The-MedicarePartDOutlookAllYears.php

100%

up to

$360 Max of 5% or $2.95 / $7.40 per