YSK: There is no real maximum out of pocket on prescriptions for Medicare Advantage insurance holders. Which means your elderly or disabled family could be drowning without the extra know.

https://en.m.wikipedia.org/wiki/Medicare_Part_D_coverage_gap

If you have a family member who is retired or on disability and they seem perplexed on how to afford their healthcare then you can help them! Some people don't realize that there's no real maximum that Medicare Advantage (MA) insurance will cover before you drop into the coverage gap. To get into it matters how much things cost both you and your insurance. To get out your own costs have to hit the catastrophic level. And once you hit catastrophic you are still going to have a (comparably small) deductible. The "true out of pocket cost" to hit catastrophic is in the thousands and if you're living in a very small income and get caught with an expensive disease (example: cancer or hep C) you need to know all the options. The ones know if are Low Income Subsidy or Medicare Supplement and sometimes will eliminate drug costs.

Most importantly the insurance provider negotiates how all medication is tiered and the cost structure. So your costs will vary depending on who is managing the MA plan. Ultimately the drug companies and the government own the vast majority of the power on health care costs to the individual and the insurance provider just does their best to make it work.

The good news is that over a couple years the gap will "close" meaning the costs will go down some over the next couple years for the majority of people.

Some elderly and disabled really struggle understanding the system and helping them sort things out would be an invaluable service.