Of the 65 million Medicare beneficiaries in 2022, 49 million are registered in Part D plans. More than half choose MA-PDs, and 47% choose PDPs.
For senior citizens, the expense of prescription medications can be a significant issue. More than 88% of persons 65 and older use at least one prescription medication monthly, and over 42% use five or more, according to a 2019 CDC survey.
Consider how Medicare Part D prescription drug coverage can result in cost savings if you take many prescriptions or are about to become eligible for Medicare shortly. For people currently on Medicare, open enrollment runs from October 15 to December 7, 2022. After that, the initial enrollment period is open to anyone turning 65 after 2022 (possibly in 2023) (IEP).
What You Should Know About 2023 Medicare Part D Plans
Here is what you need to know about Medicare Part D Plans 2023
Medicare Part D may cover prescription drug expenditures. You could need to pay some out-of-pocket costs under Part D. Here, we go over a few of these expenses.
Sharing of Part D costs
Like Medicare Part B rates are established, Medicare determines your Part D premium based on your stated income. Your Part D costs for 2023 will be determined using the income you provided for 2021. You signed up for a Part D plan at a monthly cost of $50 and reported a 2021 income of $100,000.
Expenses could consist of the following:
- The cost of a Part D plan’s monthly premium ($31.50 on average is estimated for 2023)
- A yearly deductible (up to $505 in 2023)
- A copayment or coinsurance share of plan-covered medications during the initial coverage period; A percentage of the cost of medications after the initial coverage time (once called the coverage gap/donut hole)
Some people with higher incomes will pay more for their Part D premiums. That’s called Income-Related Monthly Adjustment Amount or IRMAA.
Donut Hole: Former Coverage Gap Payments
You will enter what was formerly known as the donut hole or the Part D coverage gap if you spend more than the required amount during the initial coverage period. Although this gap was formally “filled” in 2020, you are still liable for 25% of the price of your generic and name-brand medications throughout this time.
To avoid paying a late enrollment fee, you must sign up for Part D insurance within nine months of first being eligible or within five months of turning 65 (unless your employer takes care of your coverage or you have a disability).
Best Medicare Part D Plans
Plans call for various cost-sharing adjustments for 2023, including increases and decreases in the cost-sharing percentages on different formulary tiers.
We carefully weighed copays, premiums, maximum prescription coverage, out-of-pocket costs, and the Medicare coverage gap to choose the complete Medicare Part D plans. In addition, we evaluated scores from other sources.
AARP / UnitedHealthcare
Whether you choose a low premium or low deductible plan, United Healthcare’s AARP PDPs offer a terrific value. Consider the scenario if you primarily utilize generic medications and have access to a Walgreens pharmacy.
The AARP Medicare Rx Walgreens plan from United Healthcare is a suitable choice because it has a cheap premium, no copays, and no deductible for Tier 1 medicines. In addition, UHC started promoting 2023-only plans that provide extra coverage for the Medicare donut hole.
Pros and Cons
- Additional Medicare-gap coverage
- Above average Medicare star rating
- Affordable plans, especially if you fill your prescriptions at Walgreens
- Many drugs have free mail delivery (for 90-day supplies)
- A few other plans have lower deductibles.
Out of all the 2023 available PDPs, Aetna has the lowest average premium. So, whether you need extensive prescription coverage or a cheap plan, Aetna offers what you need. Furthermore, the business ranks above average by the NCQA.
Pros and Cons
- Among all PDP suppliers, it offers the lowest national average premium
- Additional coverage during the donut hole
- Delivers free prescriptions to homes
- Excellent ranking for financial stability
- Lower customer satisfaction ratings than a few other insurers
The average Medicare star rating from the CMS for Humana, which offers PDP plans across the US, is 4 out of 5. That means most Humana members report better experiences with their plans.
Humana offers many supplementary plans with extra prescription coverage for the Medicare coverage gap for 2023. Three different plan types are available from the company:
- Humana Basic Rx Plan
- Humana Premier Rx Plan
- Humana Walmart Value Rx Plan
The premier versions provide extra prescription coverage for the Medicare gap. Tier 1 and 2 prescription deductibles are zero dollars under the Walmart Value and Premier plans.
Pros and Cons
- An average CMS star rating of 4
- Plans with low costs and no deductibles are available for several generics
- Free postal delivery and numerous generic medications with specific insurance; no copayment
- Some areas may have limited pharmacy network coverage.
Specialty Drug Tier Could Reduce Prices
Many Medicare Part D plans categorize medications into “tiers” that influence the cost-sharing proportion patients must pay. CMS, or the Centers for Medicare and Medicaid Services, endorsed the introduction of a more affordable specialty tier in 2022 for Medicare Part D plans.
This indicates that in exchange for being on the specialty or “preferred” tier, plans can bargain with drug manufacturers to obtain greater pricing for specialty-tier medications. The savings can then pass on to patients through the plans.
You may wish to check for plans that include your medication on a less-priced, “preferred” specialty tier if you currently have one or more specialty-tier prescriptions.
The prescriptions you use and the most practical pharmacies will be critical factors in determining which plan is ideal for you. However, Aetna is your best option if you rarely or never take prescription drugs and want to avoid the late enrollment fine.
Depending on which pharmacies you prefer, choose United Healthcare or Humana if you mainly use generic medications and don’t want additional gap coverage.