The preliminary analysis on 2019 stand-alone Medicare Prescription drug plan data was recently released by the Centers for Medicare and Medicaid Services (CMS); Beneficiaries are really going to benefit from the new Part D Prescription drug plan options.
Medicare beneficiaries will have more choices for their 2019 Medicare Part D PDP plans, many who stay on their current plan could see a slightly higher premium. There will be options to choose a lower-premium 2019 plan.
It is important when you choose a plan, that you select creditable coverage. Creditable coverage means the coverage is expected to pay on average as much as the standard Medicare prescription drug coverage.
2019 Stand-Alone Medicare Part D Plan Options
Sure, there was an increase in plans last year, but this coming 2019 there will be even more stand-alone Medicare Part D plans offered in every state. In 2018, the national average of PDPs was only 23. For 2019, there is an increase to 26 PDP plans offered across the country.
The best part, no state will experience a decrease in the amount of prescription drug plans offered. Florida Medicare beneficiaries will be excited to see the six additional plan choices, and most other states will see between three and five additional PDP plans available.
Lower Premium Plan Options
Medicare Beneficiaries can expect to see an increase in plan options for 2019; you may also notice that more insurance companies are offering a lower-premium option.
Medicare recipients in California, Colorado, and New Mexico can get excited about this Medicare Annual Enrollment Period; this is because they will find three additional 2019 Prescription drug plans with premiums under 25 dollars.
The lowest plan option for 2019 Medicare Part D plans will be the Texas WellCare Value Script PDP with a super low premium of $10.40. This same WellCare plan will be available in all states with a premium up to only $16.90 (Arkansas and Louisiana).
Another super competitive plan available in some areas will be the EnvisionRXPlus PDP, it will have the lowest monthly premium between $12.90 and $14.50.
The Aetna Medicare Rx Select Prescription Drug plan will have the lowest monthly premium for Medicare Beneficiaries who primarily reside in Arizona, the costs is only $12.20.
When you talk to a licensed insurance expert in your state, you’re able to find the best plan that is suitable for your lifestyle and budget.
Higher Premium Plan Options
Beneficiaries in Pennsylvania and West Virginia will have access to the most expensive Prescription Drug Plan premium, the plan is called the Blue Rx PDP Complete and it costs 156 dollars per month. This plan does have comprehensive coverage and a zero-dollar deductible, there is no doubt that it could be worth it for some beneficiaries.
If You Have Medicare, Look for Changes to 2019 Part D plans
There are going to be several new plans available nationally, and lower cost plans than in 2018. If we base enrollment off the current plan enrollment, many beneficiaries would experience an increase in premium. The average weighted Medicare Part D plan premium will increase 2% to $41.29.
This means the plan you are currently covered by for prescription drugs might be increasing the premium costs. It will be your responsibility to change your coverage to a more affordable 2019 Medicare Prescription drug plan or Medicare Advantage plan that includes prescription drugs.
Low-Income Subsidy (LIS) Benchmark Premium Changes
Many states will have the same or fewer 2019 Medicare Part D plans that qualify for the LIS $0 benchmark premium. Florida offers the smallest selection of $0 premium LIS PDP options, they continue to offer only two $0 LIS premium options.
California and Louisiana had the largest increase in LIS qualifying plans with the addition of two 2019 Prescriptions drug plans with a qualifying $0 premium.
Fewer PDP Plans with a $0 Initial Deductible
Not much has changed as far as the initial deductible stage of PDP plans from 2018 to 2019. Most 2019 plans will have an initial deductible ranging from $15 to the 2019 standard initial deductible of $415.
For example, 26 plans are available in Ohio and only 8 of those plans will have a $0 initial deductible in 2019.
The Initial Coverage Period
In 2019, all Medicare Part D plans will have the same standard Initial Coverage Limit of $3,820. The initial coverage limit is the retail value of your formulary drug purchases that determines when you enter the Donut Hole, also referred to as the Coverage Gap.
The Medicare Beneficiaries enrolled in a Medicare Advantage Prescription Drug (MAPD) plan may have a higher initial coverage limit, meaning some MAPD members will be able to buy more formulary medication before reaching the 2019 Donut Hole.
The Donut Hole
The donut hole will be going away before we know it; for now, we watch it slowly close. Medicare beneficiaries will see an increase in coverage while they are in the Coverage Gap phase. This discount will increase to a 75 percent for brand name drugs (you pay 25% of retail) and a 63 percent discount for generic medications (you’ll pay 37% of retail).
While the Coverage Gap is closing, it hasn’t gone away yet, and all Medicare Part D plans honor the Donut Hole Discount. About 23% of all stand-alone 2019 Part D plans will offer some level of additional Gap Coverage, additional to the Donut Hole Discount.
Plan Name Changes
As a Medicare beneficiary, you are probably getting used to all the annual changes that come with being on Medicare. Plan name changes are nothing new, the plans in your area may be changing their name.
For example, the 2018 First Health Part D Value Plus plan will become the 2019 Aetna Medicare Rx Value Plus Prescription Drug plan.
What Medicare Beneficiaries Need to Know
It’s obvious that every year Medicare Advantage and Prescription Drug plans change, even if only a little bit. As a Medicare Beneficiary it’s your responsibility to asses plan changes. Questions you may want to have answers to include:
- Is my doctor still covered?
- What about my specialist?
- What costs have changed from 2018 to 2019?
- Is this plan still the most affordable for me?
- Are my prescription drugs covered?
- Will mail-order prescriptions save me more money?
- Which vaccines will my plan cover?
- Are there any better or more suitable options?
While many of the changes from 2018 to 2019 plans are positive changes, you may need to change your policy. Talking to a licensed insurance expert in your state will give you the confidence you deserve when it comes to your health insurance policy.
If you enroll in a Prescription drug plan after you’re first eligible for Medicare, you may be required to pay a Part D Late Enrollment Penalty. This is not a one-time penalty and it’s your responsibility to enroll in coverage. If you have low income you may be eligible for extra help.