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PDP-Facts: Summary of State Specific
    2018 Medicare Part D Plan Landscape
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
Select a state below to review the 2018 Medicare Prescription Drug Plan Landscape.
AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY

National Statistics:
2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008

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    • New York’s 2018 Medicare Part D plan overview

    Introduction:
    Based on the 2018 Medicare Part D prescription drug plan information released by the Centers for Medicare and Medicaid Services (CMS), New York seniors and Medicare beneficiaries will find that 2018 will bring a number of changes to their prescription drug coverage and beneficiaries should be prepared to see how their current 2017 Medicare Part D plan is changing in 2018. To assist, we now have our 2018 PDP-Compare Annual Notice of Change (ANOC) tool online to show basic changes in plan coverage at PDP-Compare.com/2018/NY.

    Please note that the information we provide below is based only on stand-alone Medicare Part D prescription drug plans (PDPs).  We do not compare stand-alone drug plans directly with Medicare Advantage plans.  Unlike PDPs, Medicare Advantage plans provide coverage for Medicare Part A (in-patient hospital coverage), Medicare B (out-patient physician visits), and may include comprehensive prescription drug coverage (called MAPD plans).  Medicare Advantage plans may also include additional benefits such as dental, vision, and health club coverage.  For more information, seniors can review all Medicare Advantage plans available in their area using our 2018 MA-Finder.

    What’s new for New York’s
    2018 Medicare Part D Prescription Drug Plans

    New York 2018 Medicare Part D premium increases and decreases:
    Of the 20 Medicare Part D plans available in New York for 2018, 6 plan(s) will lower their premiums and 12 will increase their premiums. Currently, 58% of New York residents enrolled in a stand-alone Medicare Part D plan are enrolled in one of the 12 plans with a premium increase. The average premium increase for members of these plans will be $6.51 per month.

    The 2018 average monthly Medicare Part D premium in New York will decrease:
    Overall, the average monthly 2018 prescription drug plan premiums in New York will decrease 1.7% from a 2017 average monthly premium of $49.00 to a 2018 average Part D plan premium of $47.30.

    The average monthly premium discussed above consider all stand-alone Medicare Part D plans equally.  Perhaps a more telling average is the weighted average — that is, looking at each plan’s monthly premium weighted by the number of people enrolled in that particular plan.  Based on the weighted average, New York residents can expect to see a 7% increase in their monthly premiums. This means that if everyone stays in their current 2017 prescription drug plan through 2018, then across the state we can expect beneficiaries to pay 7% more for their monthly premium.

    As reference, the national average monthly Medicare Part D premium will . 

    New York will have more Medicare Part D (PDP) plan choices:
    Locally, New York residents will find that the total number of stand-alone 2018 Medicare prescription drug plans has increased from 19 in 2017 to 20 stand-alone Part D plans.

    A wide assortment of national and regional Medicare Part D plans are offered in each state or CMS region, with the average number of prescription drug plans offered per state . You can review all 2018 Medicare Part D Plans available in New York at PDP-Finder.com/2018/NY.

    As a note, if you find that your current 2017 Part D plan is not being offered in 2018, you may wish to review your Part D plan’s Annual Notice of Change (or ANOC) letter to see if you will be automatically moved to another 2018 prescription drug plan or whether you will need to actively choose a new 2018 Medicare Part D plan.

    If you are automatically switched to a new plan for any reason, please review the new plan closely.  Automatic plan switches DO NOT take into account your specific medication coverage and pharmacy needs. Check to be sure that your new plan provides the coverage you need.

    The range of monthly drug plan premiums will decrease:
    The premiums within New York will range from $12.60 (EnvisionRxPlus (PDP) in NY) to $91.20 (Express Scripts Medicare - Choice (PDP) in NY) — as compared to the 2017 New York monthly premium range of $14.60 to $106.40.

    In comparison, across the country the 2018 Medicare Part D plan premiums range from a low of to a high of .

    More Medicare Part D plans with a monthly premium under $25:
    New York residents will have more lower premium Medicare Part D (PDP) plans from which to choose. There will be 4 plans having a premium under $25, an increase from the 3 Part D plans under $25 offered in 2017.

    Changes in the Initial Coverage Limit:
    The Initial Coverage Limit (ICL) is the maximum retail value of formulary drugs you can purchase before entering the Coverage Gap (or Donut Hole).  All 2018 stand-alone Medicare Part D plans (PDPs) changed their initial coverage limit — defining when you enter the Coverage Gap.

    More Medicare prescription drug plans will offer some level of Coverage Gap protection:
    The selection of prescription drug plans with Donut Hole coverage has also changed with more companies offering 2018 Part D plans with some level of additional coverage (over the standard generic and brand-name drug discounts) for purchases made in the Coverage Gap.   In 2017, 6 plans offered plans with some form of Donut Hole coverage and in 2018 that number will increase to 7 plans.  People are reminded to see which drugs are actually covered in the donut hole because some Medicare Part D plans only cover a "few" drugs through the Coverage Gap.

    Remember, even if your Medicare Part D plan has "No Gap Coverage", you still get the standard 2018 generic drug discount of 56% and brand-name drug discount of 65%.   You can read more Donut Hole Discount here.

    More Medicare prescription drug plans are offered with enhanced options:
    New York residents will find that more Part D plans will offer enhanced prescription drug coverage options with 11 enhanced Part D plans in 2018 as compared to 10 in 2017.  Enhanced Medicare Part D coverage includes prescription drug plans that have a lower or no initial deductible and a variation of cost-sharing (for instance, copayments instead of co-insurance).  For example, in 2018, the same number of New York Part D plans will offer prescription drug coverage with a $0 initial deductible (7 plans in both 2018 and 2017).

    Low-Income Subsidy recipients in New York will have the same number of Medicare Part D plans that qualify for the $0 monthly premium:
    New York Medicare beneficiaries who qualify for full "Extra Help" will find no change in the number of Part D plans qualify for the $0 premium Low-Income Subsidy as compared to last year.  In 2017, 8 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy and this number (8 Part D plans) does not change for 2018.

    Please note, if you received "Extra Help" in 2017 and your plan does not qualify for the $0 premium in 2018, you may be automatically moved to a new Part D plan that does qualify for the $0 premium.  If this occurs, please check to be sure that your prescriptions are covered on your new plan.  If your prescriptions are not covered, you can switch to a plan that will cover your medications.

    To Summarize:
    New York seniors and Medicare beneficiaries will see more prescription drug plan choices in 2018 and can expect to see higher monthly premiums.

    In addition, behind the numbers, some of 2017’s more popular Medicare Part D plans will change their 2018 plan structure.  Some plans are adding initial deductibles or changing cost-sharing limits (for instance, how much you pay for a covered drug).

    Accordingly, beneficiaries are reminded to consider their 2018 prescription drug plan options carefully.  If you are a Medicare beneficiary and make no decision about changing your existing prescription drug coverage, you will be automatically reenrolled in your existing prescription drug plan — along with any changes that have been made in your plan’s coverage or cost for 2018.  If your prescription drug plan will be discontinued, and you are not automatically moved into a new plan, you will need to enroll in another Part D plan or you may not have prescription drug coverage in 2018.

    What is the Bottom Line?
                    Review your 2018 Medicare prescription drug plan options.

    Important Dates:
    Medicare Part D Plan Marketing begins: October 1, 2017
    Annual Open Enrollment Period: October 15, 2017 through December 7, 2017
    New Coverage begins: January 1, 2018

    For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information. You can review the 2018 New York Medicare Part D Facts page at PDP-Facts.com/2018/NY

    Questions? Please let us know by clicking here for our Customer Help Desk.

    Click here to review Medicare Part D plan statistics for the 2018 plan year.
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    • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
    • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
    • Medicare has neither reviewed nor endorsed the information on our site.
    • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
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    • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
    • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
    • Limitations, copayments, and restrictions may apply.
    • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
      Statement required by Medicare:
      "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
    • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
    • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
    • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
    • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
    • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
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    • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
    • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
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    • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.
    .