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Over 13.2 million people enrolled in a 2021 Medicare PDP will see an increase of $20 to $275 in their 2022 initial deductible

Category: Annual Medicare Plan Changes
Published on 2021-10-16 14:09:03

If your stand-alone Medicare Part D prescription drug plan (PDP) - or Medicare Advantage plan that includes drug coverage (MAPD) - has an initial deductible, you will usually pay 100% of your prescription drug costs until you have met the deductible.

For example, if your Medicare plan has a $480 deductible, you will pay the full retail price for your medications until you have spent $480 and then your plan coverage will begin (and you will only pay a portion of the retail cost, such as a $30 co-pay or 25% co-insurance on your medications).

Reminder: Low-costing formulary tiers may be excluded from your deductible.

Many 2022 Medicare Part D plans have certain drug tiers excluded from the initial deductible.  For example, you may find that your 2022 Medicare Part D plan has a $480 initial deductible, but the deductible only applies to medications on formulary Tier 3, Tier 4, and Tier 5 - and your lower-costing Tier 1 and Tier 2 drugs are covered before meeting the $480 deductible.

About 9.8 million people will see a $35 increase in their standard initial deductible.

The 2022 standard initial deductible will increase to $480 from the $445 standard deductible in 2021 and this $35 increase in deductible could impact about 9,777,000 people currently enrolled in a 2021 stand-alone Medicare Part D plan -- although many of the plan members receive "Extra Help" and do not pay the deductible -- and some of these plans exclude lower-cost generics from the deductible.

Over 3.4 million people will see an increase in their 2022 initial deductible of $70 or more.

In fact, over 3 million stand-alone Medicare Part D beneficiaries are enrolled in PDP that will have an initial deductible increase from $100 to $275.

Medicare Prescription Drug Plan

2022 Plan Name


Members Affected



% Incr.
SilverScript Choice (PDP) $480 $205 to $445 $35 to $275 7.5% to 134% in all states 3,455,120
Horizon Medicare Blue Rx Saver (PDP) $400 $150 $250 167% in NJ 9,910
Humana Premier Rx Plan (PDP) $480 $305 $175 57% in PR 3,431
Wellcare Value Script (PDP) $480 $350 $130 37% in SC 13,472
Blue MedicareRx Value (PDP) $400 $290 $110 38% in MO 4,342
Regence Medicare Script Basic (PDP) $410 $300 $110 37% in ID UT 1,886
Asuris Medicare Script Basic (PDP) $410 $300 $110 37% in OR WA 2,900
BlueCross Rx Value (PDP) $400 $300 $100 33% in SC 11,854

The Good News:  About 700,000 people will see a decrease in their initial deductible.

As in past years, some stand-alone Medicare Part D plans (PDPs) have chosen to reduce their initial deductible for the new plan year. The 687,000 members of the AARP MedicareRx Walgreens (PDP) will have a $310 deductible in 2022 down from $445 in 2021.

How to see the changes in your 2022 initial deductible.

Our PDP-Compare and MA-Compare tools highlight coverage changes for each stand-alone Medicare Part D prescription drug (PDP) and Medicare Advantage (MA or MAPD) plan and include 2021 / 2022 changes in plan features such as premium, deductible, cost-sharing and formulary size changes.  Our compare tools also show plans that will be merged or discontinued and plans that will be added in 2022.

Not sure whether you want an initial deductible?

Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about Medicare plan coverage and their 2022 Medicare Part D and Medicare Advantage plan options.

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Tips & Disclaimers
  • 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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  • 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.
  • 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.
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  • 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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  • 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.
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