With new changes in Medicare Part D prescription drug coverage from 2017 to the new 2018 plans, many benefiting from Medicare are wondering how their plan will change.
Medicare Part D, which is responsible for covering prescription drugs, is showing changes from the initial deductible to the out of pocket threshold, continuing the trend of increases from 2014-2018.
In the sections below, we’ll discuss the changes that will take effect regarding Medicare drug plans for 2018.
2018 Changes for Medicare Part D Prescription Drug Plans
Standard Medicare Part D Initial Deductible for 2018
Initial Coverage Limit for 2018 Medicare Prescription Drug Plans
Total Out of Pocket Threshold (TrOOP) for Medicare PDPs in 2018
What is the Donut Hole Coverage Gap and How Has It Changed in 2018?
However, starting in 2018, Medicare Part D policyholders will now receive a 65% discount on the total cost of brand-name drugs purchased while in the coverage gap.
This “Donut Hole Discount” consists of a 50% discount from the drug manufacturer as well as an additional 15% from Medicare. The manufacturer discount will still count towards getting you out of the coverage gap. However, the additional 15% paid by Medicare will not count towards your TrOOP.
How has Minimum Cost-Sharing Changed?
Minimum cost-sharing, which applies during the “catastrophic coverage portion”, will increase in 2018 to 5% or $3.35 (whichever is higher) for generic or preferred drugs, and 5% or $8.35, once again depending on which is greater, for all other drugs.
How has the Maximum Copay Changed?
How many Medicare Part D plans for 2018 are available?
According to KFF, Medicare beneficiaries will have 23 Medicare Part D stand-alone prescription drug plans to choose from.
How Much is the Monthly Medicare Part D Premium for 2018?
That average premium will increase by about 9%, the PDP premiums will widely vary across each stand-alone prescription drug plan. Average premiums will range from $20-$85 per month.
2018 Medicare Drug Plans Cost Sharing Tiers
Nearly all 2018 Medicare drug plans will have 5 cost-sharing tiers. However, specific copayments and coinsurance rates will again vary widely. Most stand-alone plans will charge coinsurance for higher cost specialty drugs, as well as non-preferred drugs. Thus, resulting in higher out of pocket costs for enrollees compared to when a plan charges copayments.
Medicare Low Income Subsidy Prescription Drug Plans for 2018
For those Medicare beneficiaries receiving the low income subsidy (LIS), you’ll have six premium free prescription drug plans to choose from. Those eligible for a premium-free Medicare Part D plan will pay on average $26 per month.
Compare Medicare Part D Plans for 2018
Because Medicare Part D plans are available through private insurance companies, as long as they’re approved by Medicare, monthly rates can vary depending on the plan.
It can be difficult to consider all factors affecting which plan is right for you, you can find everything you need to know about Medicare Part D using the Part D plan finder tool.