2024 Medicare Part D PDP Outlook: Fewer 2024 Medicare Part D PDP options and most people in 2023 plans may pay higher 2024 Part D premiums
An
initial review of the stand-alone 2025
Medicare Part D prescription drug plans (
PDPs) recently
released by the Centers for
Medicare and Medicaid Services (CMS), shows that Medicare beneficiaries will
have fewer 2024 stand-alone Medicare Part D options and most current plan members will pay
higher 2024 monthly PDP premiums
(unless they enroll in a lower-premium 2024 Medicare Part D or Medicare
Advantage plan).
Here are highlights of the 2025 stand-alone Medicare Part D PDP landscape from our
PDP-Facts.com analysis:
(1) There will be 26% fewer 2025 stand-alone Medicare Part D plan options.
The total number of
stand-alone 2025 Medicare Part D prescription drug plans
across the country will decrease 11.5%
to 709 plans from 801 PDPs currently offered in 2023 -- a loss of 92 plans. The average number of stand-alone 2024 Part D plans offered in
each state is decreasing to
21
plans down from 24 plans per state in 2023.
Alabama and
Tennessee will
offer the most stand-alone 2024 Medicare Part D plan choices (
24), the
same number as offered in 2023.
New York
will offer the smallest number of 2024 PDPs at 15 Medicare Part D plans.
Arizona will see the largest PDP decrease – losing seven (7) PDP options in 2024.
(2) The average 2024 stand-alone
Medicare Part D premium will increase 21%.
In
late-July,
CMS forecasted a 1.8%
decrease in the average Medicare Part D premium. CMS based their calculation on both
stand-alone Medicare Part D PDPs and Medicare Advantage plans with drug
coverage (
MAPDs). Our preliminary
analysis of
only the stand-alone 2024 Medicare Part D PDPs indicates a
21% premium increase across all PDPs, based on current plan enrollment.
(3) As many as 73%
of current 2023 Medicare Part D plan members (not considering LIS eligibility) may
have increases in 2024 monthly premiums.
When the 2024 Part D PDP premiums are weighted by
current 2023 Part D plan enrollment, we estimate that up to 73% of all Medicare Part D beneficiaries
currently enrolled in a stand-alone 2023 Medicare Part D plan will see an average
increase of $14.34 in their 2024 monthly premium -- unless they change coverage
to a more affordable 2024 Medicare Part D or Medicare Advantage plan that
includes prescription drug coverage (
MAPD).
You can
read more about changes to the Medicare Part D PDP premiums.
Important Extra Help reminder: If you are eligible
for the Medicare Part D Low-Income Subsidy (
LIS) and chose your own Part D plan
in the past, you will receive a
tan-colored notice from Medicare
in early-November, informing you about your upcoming premium increase.
(4) Expect slightly fewer low-premium 2024 Medicare Part D
plan options.
Our analysis
of the 2024 PDP landscape
also found a decrease in the number of PDPs with a premium under $25.
Just over 21% of all stand-alone Medicare Part D plans will have a
premium
under $25 per month as compared to 23% of the 2023 PDPs with a premium
under $25. For example, Medicare beneficiaries in
Texas
will find five (5) fewer 2024 Medicare Part D plans with premiums under $25
as
compared to 2023. On
a positive note, as we highlight in the next section, a Medicare Part D PDP with a premium of $0.50 or less is available in most states.
In addition, Medicare beneficiaries in
Illinois and
Texas will find that 23% of all 2024 Medicare Part D plans have premiums under $25. The chart below shows the total number of stand-alone Medicare Part D plans as compared to the number of PDPs across the country with a premium under $25.
(5) Lows and Highs: The lowest premium and highest premium stand-alone
2024 Medicare Part D plans.
In most states
the lowest 2024 Part D premium will be the Wellcare Value Script (PDP) with a
premium of
$0.00 to
$0.50. The lowest PDP premium in 2023 was the SilverScript SmartSaver (PDP) in
Oregon
and
Washington
State with a premium of $1.60 ($3.30 per month in 2024).
The 2024 Medicare Part D plan with the lowest monthly premium - and a
$0 initial deductible -
is the
Missouri Blue MedicareRx Plus (PDP) plan, with a premium of $68.90.
The
Wellcare Medicare Rx Value Plus (PDP) is the lowest priced $0 deductible plan in most other states with a premium of about $79.
The 2024 Medicare Part D
plan with the most expensive premium is the Blue Rx Complete (PDP) in
Pennsylvania and
West
Virginia at
$195.10 per month.
(6) Fewer 2024 Medicare Part D plans qualify for the LIS $0 premium.
There will be fewer 2024 Medicare Part D plans qualifying for the state’s
Low-Income
Subsidy
(LIS) $0
benchmark
premium
across the country.
The states offering the smallest selection of $0 premium LIS plans are
Florida,
Illinois,
Missouri,
Nevada,
New Jersey,
New York,
Ohio, and
Texas – each with only two (2) $0 premium LIS plans
in 2024.
Wisconsin will offer the largest number of $0 premium LIS plans
(7 plans).
You can
click
here to
read more about $0 premium LIS plan availability and see a chart of how the
average number of $0 LIS-qualifying Medicare Part D plans has changed since
2007.
(7) 85% of stand-alone 2024 Medicare Part D
plans have an initial deductible.
As was true in 2023, most 2024 Medicare Part D plans will have an initial
deductible ranging from $100 to the
2024
standard initial deductible of $545.
In fact, about 85% of all 2024
stand-alone Medicare Part D PDPs
will have some initial deductible - with the vast majority of these plans having a $545 initial deductible.
As an example, of the
21
plans available in
Florida,
only
four 2024
stand-alone Medicare Part D plans will have a $0 initial deductible.
However, over 50% of 2024 Medicare Part D PDPs
that include a deductible will exclude one or more low-costing drug tiers from the initial
deductible.
(8) 29% of 2024 Medicare Part D plans will offer supplemental Donut Hole
coverage.
The
2024
Donut Hole discount remains
75% for all formulary medications -- you pay 25% of retail for both brand-name
and generic formulary medications purchased while in the Coverage Gap.
Even better, about 29% of all stand-alone 2024 Part D plans offer some level of
additional
gap coverage beyond
the Donut Hole discount. For brand-name
drug purchases in the Donut Hole, the 70% brand-name drug manufacturer’s Donut
Hole discount is applied to this supplemental gap coverage.
(9) All 2024 Medicare Part D plans
will offer insulin at a $35 (or less) copay.
Based on the
Inflation Reduction Act, all 2024 stand-alone Medicare Part D prescription drug
plans and Medicare Advantage plans with drug coverage (
MAPDs) will offer all insulin found on the
plan’s formulary for a copay of $35 (or less) through all phases of Part D
coverage.
New in 2024, cost-sharing in the Catastrophic
Coverage phase will be eliminated for all Medicare beneficiaries.
(10) All 2024 Medicare Part D plans
will offer Part D vaccines at a $0 copay.
Also based on the
Inflation Reduction Act, all 2024 stand-alone Medicare Part D prescription drug
plans and Medicare Advantage plans with drug coverage (MAPDs) will offer $0
cost-sharing for vaccines that are recommended by the Advisory Committee on
Immunization Practices (
ACIP), such as Shingles and Pneumonia vaccines.
(11) Remember, all Medicare plans change each year.
You can review changes in Medicare plan features from 2023 to 2024 using our
PDP-Compare.com/2024 or
MA-Compare.com/2024.
- Your formulary (drug list) will change year-to-year, see
FormularyBrowser.com/2024 (updated as data is available)
- The 2024 standard deductible is increasing to $545, see
PDP-Finder.com/2024 or
MA-Finder.com/2024
- The 2024 initial coverage limit (Donut Hole entry) is increasing to $5,030
- The 2024 Total Out-of-Pocket (TrOOP) threshold is increasing to $8,000
- Beneficiary cost-sharing in the Catastrophic Coverage phase is eliminated.
Learn More: How 2024 Medicare Part D drug coverage is changing and will help save on prescription costs.
Need an overview of stand-alone
Medicare Part D plans in your area?
If you would like to see an overview of your state’s Medicare
Part D plan landscape, please use the following links to our interactive 2024
PDP-Facts:
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
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
National Statistics.
Please note: The above
information is from our Medicare Part D
plan landscape summaries and based on
stand-alone Medicare Part D prescription drug plans – and does not
include the U.S. territories.
Question: Can we skip the
numbers and just read about our state’s Medicare Part D plan changes?
Yes you can. We provide a written
summary of how 2023 Medicare Part D plans are changing in 2024 for each state,
just look for the "
Summarized
in Plan Text" link on our
PDP-Facts.com state pages. For example, you can
click here to read more
about drug plan changes in Arizona, such as:
"
Arizona 2024 Medicare Part D premium increases and decreases:
Of the
28 Medicare
Part D plans available in Arizona for 2024, 6 plan(s) will lower their
premiums and 20 will increase their premiums. Currently, 68.4% of Arizona
residents enrolled in a stand-alone Medicare Part D plan are enrolled in one of
the 20 plans with a premium increase. The average premium increase for members
of these plans will be $6.80 per month."
What about 2024 Medicare Advantage plans?
The 2024 Medicare Advantage plan landscape summary will be presented in our
next newsletter. A number of 2024 Medicare Advantage plans
(
MA/MAPD /
MSA /
SNP) may be available
in your area and may include prescription drug coverage, along with Medicare
Part A (hospitalization coverage), Medicare Part B (out-patient and physician
coverage), and additional healthcare (and non-health-related) benefits.
You can use our Medicare Advantage plan finder (
MA-Finder.com) for an overview of plans in your area (enter your ZIP
to get started).
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