Medicare Prescription Drug (Part D) Cost Estimator (2025)
Estimate your total annual prescription costs under different Medicare Part D plans, including premiums, copays, deductibles, and coverage-gap expenses.
This estimator helps Medicare beneficiaries estimate annual prescription drug costs under various Part D plan tiers. It factors in premiums, deductibles, copays, coverage gap exposure, and catastrophic phase spending based on 2025 CMS guidelines.
Monthly Premiums
Paid to your plan provider monthly
Annual Deductible
You pay this before coverage begins
Initial Coverage
Plan pays majority of costs
Coverage Gap
You pay 25% of drug costs
Catastrophic Coverage: After $8,000 out-of-pocket, plan covers 95%, you pay 5%
| Category | National Average 2025 | Notes |
|---|---|---|
| Monthly Premium | $48 | Range $0 - $100 |
| Annual Deductible | $545 (max) | Some plans have $0 deductible |
| Coinsurance in Gap | 25% | Brand & generic drugs |
| Catastrophic Threshold | $8,000 | Total true out-of-pocket |
| Typical Annual Drug Spending | $3,400 - $6,500 | Varies by user profile |
per year with Basic plan
per year with Enhanced plan
per year with Premium plan
What is the coverage gap?
The "donut hole" where you pay 25% of drug costs until reaching catastrophic coverage.
Are generic drugs covered in every plan?
Most Part D plans cover generics, but tiers and copays vary.
What is the maximum out-of-pocket limit?
$8,000 for 2025 (CMS threshold).
Does Extra Help (LIS) eliminate premiums?
Yes – low-income beneficiaries often pay $0 premium and small copays.