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A first look at the 2019 stand-alone Medicare Part D prescription drug plan (PDP) landscape

Category: Annual Medicare plan changes
Published: Sep, 28 2018 10:09:10
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The Centers for Medicare and Medicaid Services (CMS) has released an initial preview of the 2019 stand-alone Medicare Part D prescription drug plans (PDPs) and the following is a brief overview of the PDP landscape.

Please remember that this 2019 PDP data was compiled on September 20, 2018 and is subject to CMS change as the Medicare plan contracts are finalized.

For an overview of the 2019 Medicare Part D landscape, we have our 2019 PDP-Facts (PDP-Facts.com) section online and you can click here to see our analysis of the 2019 Medicare Part D plan landscape on a national and state-by-state basis.
  • On a national basis, there will be more stand-alone Medicare Part D prescription drug plan (PDP) options in 2019.  The number of Medicare Part D plans across the country increased from 782 plans in 2018 to 901 PDPs in 2019. In addition, a higher percentage of 2019 Medicare Part D plans will offer enhanced (EA) designs features such as lower initial deductibles, but fewer plans will offer a $0 deductible.

  • The average premium for stand-alone Medicare Part D plans will decrease 10% in 2019.
    The lowest 2019 Medicare Part D premium will be $10.40 and the highest monthly premium will be $156.

  • About 60% of people currently enrolled in a Medicare Part D plan will see a premium increase in 2019.
    The average monthly premium weighted by current Medicare Part D plan enrollment will increase in 2019 – meaning many people may wish to look for lower-premium Medicare Part D plans in 2019.

  • On a national basis, just slightly fewer Medicare Part D plans will qualify for the $0 LIS benchmark premium.  However, some states (such as California) will see an increase in LIS qualifying Medicare Part D plans.
How does your state compare to the nation-wide changes in Medicare Part D plan landscape? Here are a few state-specific examples of what you can expect from stand-alone 2019 Medicare Part D plans across the country.
  • More stand-alone Medicare Part D prescription drug plan options in 2019
    In 2019, Florida will offer 27 stand-alone Medicare Part D plans. Florida currently offers a total of 21 stand-alone 2018 Medicare Part D plans. As a historical reference, back in 2014 Florida offered 35 Florida stand-alone PDPs.

    As another example, Pennsylvania and West Virginia Medicare Part D beneficiaries will find 30 stand-alone Medicare Part D plan options in 2019, as compared to 26 PDP options in 2018.

  • More lower-premium 2019 Medicare Part D plan options.  Six 2019 California stand-alone Medicare Part D plans will have a monthly premium under $25 as compared to three 2018 Part D plans with a premium under $25. The 2019 California Medicare Part D plan with the lowest premium is the 2019 EnvisionRxPlus (PDP) with a monthly premium of $12.90. The 2018 California Medicare Part D plan with the lowest premium is the Aetna Medicare Rx Select (PDP) with a premium of $19.70.

  • More Medicare PDPs will have an initial deductible.
    The 2019 standard Medicare Part D initial deductible will increase to $415 from $405 and more Medicare Part D plans will have an initial deductible in 2019. For example, in 2019, 20 of the 27 Texas Medicare Part D plans will have an Initial Deductible ranging from $100 to the standard deductible of $415.

  • All 2019 Medicare Part D plans will be able to take advantage of the 2019 Donut Hole discount that is increasing to 75% for brand-name drugs (you pay 25% of retail in the Donut Hole for brand drugs) and the generic Donut Hole discount will increase to 63% (you will pay 37% of retail for generic medications). In Ohio, six 2019 Medicare Part D plans will also offer some coverage in the Donut Hole or Coverage Gap – in addition to the Donut Hole discount.

  • Some states will see an increase in the number of Medicare Part D plans qualifying for the Low-income Subsidy (LIS) $0 premium.  California will have a selection of seven 2019 Medicare Part D plans qualifying for the LIS $0 premium, whereas only five LIS PDP options were available in 2018.

    Alternatively, Texas will be losing two LIS qualifying Medicare Part D plan in 2019 and lower-income Texas residents will have access to five 2019 Medicare Part D plans qualifying for the state’s Low-Income Subsidy (LIS) $0 premium benchmark.

  • Plan Mergers and Changes.  As in past years, some Medicare Part D plans will be merged into other plans or plan Members will be "cross-walked" into other Medicare Part D plans.  For example, Aetna announced that the company has entered into an agreement to divest all Medicare Part D prescription drug plans (PDPs) to a subsidiary of WellCare, although 2019 Aetna Medicare Part D plan members should not be affected by this transition.
As a reminder!
The Annual Enrollment Period (AEP) for 2019 Medicare Part D plans and Medicare Advantage plans begins on Monday, October 15th and continues through Friday, December 7th – with new Medicare plan coverage beginning on Tuesday, January 1, 2019.  Starting October 1st, you can telephone Medicare at 1-800-633-4227 to learn more about your 2019 Medicare Part D and Medicare Advantage plan options.


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