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A. Schuyler
A. Schuyler, Research Analyst
Category: General
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Experience:  30 years in research
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My Mom is on Medicare...Is there a 20% deductible on her medications

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My Mom is on Medicare...Is there a 20% deductible on her medications as my sister tries to make her think and I have told Mom there are no 20% deductibles with Medicare,I am right aren't I !???...Thank you


Welcome to our site and thanks for your question. My name isXXXXX and I will do whatever I can to help you.


Which Medicare Drug Plan does your mother have? The costs can vary. Often there is a deductible plus a co-insurance payment for each prescription filled. The co-insurance is often in "tiers" with costs for some drugs higher than costs for others. You will need to know the type of insurance to determine what the costs are.


Looking forward to hearing from you,





Customer: replied 4 years ago.

its medicare and she has an HMO.....She is 91 and medicare from what Ive heard pays most everything!....Im on medicade myself and I get 4 prescrpitions a month and I only pay like $ 4,and pays everything else,but medicare I thought was to pay 100%,esspecially hers and another elderly woman I know...Just Moms medications alone a !.month are thousands of dollars and Im just not buying the 20% deductible

You will need to know which HMO she has (which company provides it, such as Cigna, Blue Cross Blue Shield, Aetna, etc.). Each Medicare HMO company has its own formulary and 20% copay is one typical payment option. Others have "tiers" that may charge $10 copay for a Tier 1 drug, $25 for a Tier 2 drug $50 for a Tier 3, etc.


While hospital and outpatient services are covered under Medicare and along with the HMO may result in no charges, prescription medications are not covered 100% under any plan I've ever seen.


The word you want is copayment, not deductible. Some companies don't pay anything until a certain deductible per year is met. This depends on the company and the exact HMO she has.


Please let me know if you have questions.





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