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Important Medicare Part D Updates

The Medicare Part D prescription costs have changed in 2024. Part D may help cover the cost of prescription drugs like ENTRESTO®.

According to the Medicare and You 2024 handbook,* you will continue to pay 25% of the cost for your generic and brand-name prescription drugs. This is after you meet your initial deductible.

Track your year-to-date costs and Part D coverage phases

Medicare will send you monthly statements with information on how much you’ve spent on prescription drugs and what phase your Medicare Part D coverage is in.

1

Deductible Phase:

  • You'll pay 100% of your deductible first, with a co-pay of up to $545
2

Initial Coverage Phase:

  • Then, you’ll pay your plan’s co-pay and coinsurance for each of your prescriptions
  • You’ll pay that amount until you and your insurance have paid $5030 in total for all of your prescriptions
3

Coverage Gap Phase:

  • You’ll pay no more than 25% of the cost of your plan’s covered brand-name prescription drugs
  • When the total amount paid for your prescription drugs reaches $8000, the coverage gap is over
  • For brand-name drugs, this includes 70% of manufacturer discount, plus deductibles and co-pays†‡
4

Catastrophic Coverage Phase†‡:

After your total yearly out-of-pocket costs reach $8000, you pay only:

  • $4.50 for generic drugs,
  • $11.20 for brand-name drugs, or
  • 5% of the retail cost for the rest of 2024 (whichever is highest)
  1. Clicking this link will open an independent third party website subject to its own Terms of Use and Privacy Policy. Novartis is not responsible for third party content and makes no representations as to the accuracy of information from third parties.
  2. Based on Medicare Part D Standard Benefit coverage (not applicable if you receive full or partial low-income subsidy). You may pay a small portion of the pharmacy dispensing fee, approximately $1-$3.
  3. Estimates based on a $545 deductible and 25% coinsurance in the coverage gap phase for all brand-name drugs with a 70% manufacturer discount being applied for all brand-name drugs.

The information provided in this communication is not a guarantee of coverage or payment (partial or full). Actual benefits are determined by each plan administrator in accordance with its respective policies and procedures. Nothing herein may be constructed as an endorsement, approval, recommendation, representation, or warranty of any kind by any plan or insurer referenced herein. This communication is solely the responsibility of Novartis Pharmaceuticals Corporation.

Medicare coverage will
change in 2024

For more information on changes to come, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).*