Medicare Part D Cost Calculator

Estimate your annual Medicare Part D prescription drug costs including premiums, deductibles, copays, and the coverage gap.

Results

Visualization

How It Works

Medicare Part D covers prescription drugs through private insurance plans. Costs include a monthly premium, annual deductible, copayments during initial coverage, costs during the coverage gap (donut hole), and catastrophic coverage.

The Formula

Total OOP = Premiums + Deductible + Initial Copays + Gap Costs + Catastrophic Costs

Variables

  • Deductible — 2025 maximum is $590
  • Initial Coverage — You pay 25-35% of drug costs up to ~$5,030
  • Gap/Donut Hole — You pay 25% of brand-name and generic costs
  • Catastrophic — After ~$8,000 total, you pay only 5%

Example

With $5,000 in annual drug costs, $33/month premium, $590 deductible: ~$396 premiums + $590 deductible + ~$1,320 copays = ~$2,306 total.

Tips

  • Compare plans annually during Open Enrollment (Oct 15 - Dec 7) as formularies change.
  • Use the Medicare Plan Finder at medicare.gov to compare costs for your specific drugs.
  • Low-income seniors may qualify for Extra Help (LIS) which dramatically reduces Part D costs.
  • The coverage gap (donut hole) has been largely closed by the Inflation Reduction Act — you now pay 25% max.
  • The $2,000 annual out-of-pocket cap (starting 2025) provides significant protection for high-cost drugs.