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Information update: the 2023 Medicare Part D and Medicare Advantage 30-day cost-sharing and health benefit information is now online at Q1Medicare.com

Category: Annual Medicare Plan Changes
Published: Oct, 05 2022 08:10:06


With the latest release of Medicare plan data from the Centers for Medicare & Medicaid Services (CMS), the Q1Medicare.com Medicare Part D Plan Finder, Medicare Advantage Plan Finder, and other online tools have been updated with the following 2023 Medicare Part D prescription drug plan information, including:
  • 30-day prescription drug cost-sharing - both co-payment (such as $1 for Tier 1 drugs) and co-insurance (such as 25% of retail) for each formulary tier.

  • Formulary (Drug List) size - we now have the total number of drugs included on each plan’s formulary - represented by unique national drug codes (NDCs).  Drug list details will be added as soon as the data is released.

  • Initial Coverage Limits (ICL) - the ICL is the retail value of medications that you can buy before entering the 2023 Donut Hole or Coverage Gap.  The standard ICL for 2023 is $4,660.  The ICL is online for all 2023 Medicare Advantage (MAPDs) and stand-alone Medicare Part D prescription drug plans (PDPs).

  • Full- and partial-LIS premiums - the Low-Income Subsidy monthly premium information is online and you can see plan premiums for a 100%, 75%, 50%, and 25% LIS-subsidy.  You can click here to learn more about the 2023 LIS $0 qualifying plans and partial-LIS premiums.

  • Medicare Advantage Plan Health Plan Benefits & Maximum Out-of-Pocket Limits (MOOP)-Medicare Part A and Part B health care coverage, supplemental benefits, Medicare Part B Giveback amount, and MOOP are online for all 2023 Medicare Advantage plans, including, MA, MAPD, MMPs, and SNPs.
A note on the current 2023 data and additional data updates:
We will include the Medicare plan Star Ratings and Medicare prescription drug (formulary) details including drug tiers excluded from the deductible, cost-sharing for all phases and pharmacy types as soon as released.


Q1Medicare.com tools available to review 2023 Medicare plans
  • Reviewing 2023 stand-alone Medicare Part D prescription drug plans (PDPs)?
Our 2023 Medicare Part D prescription drug plan finder (or PDP-Finder) can be found directly at PDP-Finder.com.  To begin, you can click on the state abbreviation (such as WI for Wisconsin) or just choose your state from the from the drop-down list, scroll down and hit “Click to Find Plans”. You can then view all available stand-alone Medicare prescription drug plans in your area.  You can also enter additional search criteria to shorten your results list.

As an example, click on the link below to see the 23 stand-alone Medicare Part D plans available to Floridians in 2023.  Again, you can just choose a new state to see the Medicare Part D plans offered in your area: PDP-Finder.com/FL.

PDP-Finder showing an example of all stand-alone Medicare Part D plans in a selected state or Service Area
  • Comparing stand-alone Medicare Part D prescription drug plan (PDP) changes from 2022 to 2023?
Medicare plans can change every year and if you would like an overview of how each 2022 prescription drug plan will change in 2023, you can use our PDP-Compare tool.  PDP-Compare.com shows changes in premiums, deductibles, cost-sharing, and plan names for all Medicare Part D plans. 

PDP-Compare has also been updated to include plan crosswalks – plans whose members will be automatically transitioned to a different plan for 2023.  To get you started, you can click here for an example of how all 2022 Medicare Part D plans in Arizona will change in 2023 (again, you can change the state in the drop-down-box to your home state).

PDP-Compare showing an example of how Medicare Part D plans can change year to year
  • Reviewing all 2023 Medicare Advantage plans in your area?
Our 2023 Medicare Advantage plan finder (or MA-Finder) has been updated and can be found directly at: MA-Finder.com or include your ZIP code in the URL to go right to all plans available in your Service Area:  MA-Finder.com/11206.

Similar to our PDP-Finder, the 2023 MA-Finder allows you to view all 2023 Medicare Advantage plans found in your area by just entering your ZIP code and then tapping “Click to Find Plans”.  The 2023 Medicare Advantage plan information now includes monthly plan premiums, drug plan coverage (if available), the plan’s maximum out-of-pocket limit (or MOOP), initial coverage limit, Medicare Part B Giveback amount, and prescription drug 30-day cost-sharing.  You can click on the “Details” button or the plan’s name to review a Medicare Advantage plan’s medical benefits and coverage details.

MA-Finder showing an example of all Medicare Advantage plans in a selected ZIP Code or country Service Area




  • Comparing Medicare Advantage plan changes from 2022 to 2023?
As with our PDP-Compare tool, our MA-Compare tool shows how each 2022 Medicare Advantage plan in your area is changing for 2023.  Begin by entering your ZIP code and selecting any features you would like, if you want to narrow your search or include your ZIP in the URL: MA-Compare.com/33142.  To get you started, you can click here for an example of how all 2022 Medicare Advantage plans in Summit County, Ohio are changing in 2023 – then just change the ZIP code to whatever you wish.

MA-Compare showing an example of how Medicare Advantage plans can change year to year

Reminder:  No need to rush.
The annual Open Enrollment Period for 2023 Medicare Part D plans and Medicare Advantage plans begins on October 15th and continues through December 7, 2022.  Your new Medicare plan coverage will begin on January 1, 2023.

Questions?
If you have any general questions about Medicare Part D plans or Medicare Advantage plans, please let us know.
You can click here for our online Help Desk to submit a question.

For more detailed questions, we suggest that you speak with a Medicare representative at 1-800-Medicare (1-800-633-4227 TTY 1-877-486-2048).






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Tips & Disclaimers
  • 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.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • 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.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • 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.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • 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.