Deductible Stage
If you select the Farm Bureau Essential Rx plan with a deductible, you will pay all of your drug costs until you spend $545 in 2024. If you select the Farm Bureau Select Rx plan you do not have a deductible.
2023 Farm Bureau Select Rx Deductible - $0
2024 Farm Bureau Select Rx Deductible - $0
2023 Farm Bureau Essential Rx Deductible - $505
2024 Farm Bureau Essential Rx Deductible - $545
Initial Coverage Stage
If your plan does not have a deductible, you start in the Initial Coverage Stage. If your plan has a deductible, you enter the Initial Coverage Stage once your deductible is met.
During this stage, the plan pays its share of the cost of your drugs and you pay your share of the cost. Depending on the Tier Level of your prescription drug, you will pay either a set copayment or coinsurance.
You stay in this stage until your total drug costs for the year total $4,660 in Plan Year 2023 and $5,030 in Plan Year 2024. Total drug costs are your payments plus the plan’s payments.
Coverage Gap Stage
During the Coverage Gap Stage, the Medicare Coverage Gap discount program provides 70% manufacturer discounts on brand name drugs. This discount is automatically applied at the pharmacy. The plan also provides some coverage for generic drugs during this stage.
Brand Name Drugs: You pay 25% (plus a portion of the dispensing fee) and the plan pays the remaining 5%.
Generic Drugs: You pay 25% of the price and the plan pays 75%.
You stay in the Coverage Gap Stage until your year-to-date out-of-pocket costs reach $7,400 in Plan Year 2023 and $8,000 in Plan Year 2024. The out-of-pocket costs do not include what the plan has paid for your prescription drugs.
Catastrophic Stage
Plan Year 2023
Once your out-of-pocket costs reach $7,400 in Plan Year 2023 and $8,000 in Plan Year 2024, you enter the Catastrophic Stage. During this stage, the plan will pay most of the costs for your prescription drugs for the rest of the calendar year in 2023.
Your share of the cost for a covered drug will be either coinsurance or copayment, whichever is the larger amount:
- 5% of the cost of the drug; or
- $4.15 in Plan Year 2023 for generic drugs or $9.85 and $10.35 in Plan Year 2023 for all other drugs.
Plan Year 2024
Once you and others on your behalf have spent $8,000 in drug costs in Plan Year 2024, the plan pays the full cost of your covered Part D drugs and you pay nothing.