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 $505 deductible, you will pay the full retail price for your medications until you have spent $505 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.

Although most stand-alone Medicare Part D drug plans (and some Medicare Advantage plans) have an initial deductible, many 2023 Medicare Part D plans have certain drug tiers excluded from the initial deductible.  For example, you may find that your 2023 Medicare Part D plan has a $505 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 even before you have met the $505 deductible.

About 14 million people will see a $25 increase in their standard initial deductible.

Each year standard Medicare Part D plan designs change and in 2023, the annual standard initial deductible will increase to $505 from the $480 standard deductible in 2022 and this $25 increase in deductible could impact about 14,049,495 people currently enrolled in a 2022 stand-alone Medicare Part D plan -- although many of the plan members receive "Extra Help" and do not pay the deductible (or pay a reduced deductible based on their level of Extra Help)  -- and, as noted, many of these drug plans exclude lower-cost generics from the deductible.

Some people will see a larger increase in their initial deductible beyond the $25 increase in the standard initial deductible.

With changes in Medicare Part D plan coverage, over 909,000 people will see an increase in their 2023 initial deductible of $45 or more.  As an example, over 78,000 stand-alone Medicare Part D beneficiaries are enrolled in a MediBlue Rx Standard PDP that will have an initial deductible increase from $75 to $155.

The following table illustrates other 2023 initial deductible increases.

The Good News:  About 820,000 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 747,000 members of the Humana Premier Rx Plan (PDP) will have a $300 deductible in 2023 down from $480 in 2022 -- and Humana Premier Rx Plan (PDP) members in AR, MO, PA and WV will have a deductible of $200.

How to see the changes in your 2023 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 2022 / 2023 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 2023.

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 2023 Medicare Part D and Medicare Advantage plan options.