North Carolina’s 2019 Medicare Part D plan overview
|Based on the 2019 Medicare Part D prescription drug plan information released by
the Centers for Medicare and Medicaid Services (CMS), North Carolina seniors and Medicare
beneficiaries will find that 2019 will bring a number of changes to their prescription drug
coverage and beneficiaries should be prepared to see how their current 2018 Medicare Part D
plan is changing in 2019. To assist, we now have our 2019 PDP-Compare Annual Notice of Change (ANOC) tool
online to show basic changes in plan coverage at PDP-Compare.com/2019/NC.
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 2019 MA-Finder.
What’s new for North Carolina’s
|North Carolina 2019 Medicare Part D premium increases and decreases:|
Of the 28 Medicare Part D plans available in North Carolina for 2019, 9 plan(s) will lower their premiums and 12 will increase their premiums. Currently, 57.5% of North Carolina 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 $4.08 per month.
|The 2019 average monthly Medicare Part D premium in North Carolina will decrease:|
Overall, the average monthly 2019 prescription drug plan premiums in North Carolina will decrease 3.59% from a 2018 average monthly premium of $48.35 to a 2019 average Part D plan premium of $44.76.
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, North Carolina residents can expect to see a 0% increase in their monthly premiums. This means that if everyone stays in their current 2018 prescription drug plan through 2019, then across the state we can expect beneficiaries to pay 0% more for their monthly premium.
As reference, the national average monthly Medicare Part D premium will .
North Carolina will have more Medicare Part D (PDP) plan choices:
Locally, North Carolina residents will find that the total number of stand-alone 2019 Medicare prescription drug plans has increased from 24 in 2018 to 28 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 2019 Medicare Part D Plans available in North Carolina at PDP-Finder.com/2019/NC.
As a note, if you find that your current 2018 Part D plan is not being offered in 2019, 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 2019 prescription drug plan or whether you will need to actively choose a new 2019 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 North Carolina will range from $14.50 (EnvisionRxPlus (PDP) in NC) to $96.80 (Blue Medicare Rx Enhanced (PDP) in NC) — as compared to the 2018 North Carolina monthly premium range of $12.60 to $115.70.
In comparison, across the country the 2019 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:
North Carolina residents will have more lower premium Medicare Part D (PDP) plans from which to choose. There will be 6 plans having a premium under $25, an increase from the 5 Part D plans under $25 offered in 2018.
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 2019 stand-alone Medicare Part D plans (PDPs) changed their initial coverage limit — defining when you enter the Coverage Gap.
Fewer 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 fewer companies offering 2019 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 2018, 8 plans offered plans with some form of Donut Hole coverage and in 2019 that number will decrease to 6 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 2019 generic drug discount of 63% and brand-name drug discount of 75%. You can read more Donut Hole Discount here.
More Medicare prescription drug plans are offered with enhanced options:
North Carolina residents will find that more Part D plans will offer enhanced prescription drug coverage options with 17 enhanced Part D plans in 2019 as compared to 12 in 2018. 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 2019, the same number of North Carolina Part D plans will offer prescription drug coverage with a $0 initial deductible (8 plans in both 2019 and 2018).
Low-Income Subsidy recipients in North Carolina will have the same number of Medicare Part D plans that qualify for the $0 monthly premium:
North Carolina 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 2018, 7 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy and this number (7 Part D plans) does not change for 2019.
Please note, if you received "Extra Help" in 2018 and your plan does not qualify for the $0 premium in 2019, 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.
North Carolina seniors and Medicare beneficiaries will see more prescription drug plan choices in 2019 and can expect to see higher monthly premiums.
In addition, behind the numbers, some of 2018’s more popular Medicare Part D plans will change their 2019 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 2019 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 2019. 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 2019.
What is the Bottom Line?
Review your 2019 Medicare prescription drug plan options.
Medicare Part D Plan Marketing begins: October 1, 2018
Annual Open Enrollment Period: October 15, 2018 through December 7, 2018
New Coverage begins: January 1, 2019
For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information. You can review the 2019 North Carolina Medicare Part D Facts page at PDP-Facts.com/2019/NC
Questions? Please let us know by clicking here for our Help Desk.
Click here to review Medicare Part D plan statistics for the 2019 plan year.