2023 Medicare Part D plan outlook: More 2023 Medicare Part D PDP options and most people in 2022 plans may pay higher 2023 Part D premiums
An
initial review of the stand-alone 2023
Medicare Part D prescription drug plans (
PDPs)
recently
released by the Centers for
Medicare and Medicaid Services (CMS) shows that Medicare beneficiaries will
have more 2023 Medicare Part D PDP options and most current plan members will pay
higher 2023 monthly PDP premiums
(unless they enroll in a lower-premium 2023 Medicare Part D or Medicare
Advantage plan).
Here are highlights of the 2023 stand-alone Medicare Part D landscape from
our
PDP-Facts.com analysis:
(1) There will be
more 2023 stand-alone Medicare Part D plan options.
The total number of stand-alone 2023 Medicare Part D prescription drug
plans
across the country will increase 4.6% to 801
plans from 766 plans currently offered in 2022 -- a gain of 35 plans.
The
average number of 2023 Part D plans offered in each state is increasing to
24
plans up from 23
plans per state in 2022.
Arizona will continue offer the most stand-alone 2023 Medicare Part D plan
choices (
28), up from 27 plans offered in 2022.
New York will offer the lowest
number of 2023 PDPs at 19 Medicare Part D plans, the same as currently offered in 2022.
Alabama
and
Tennessee
will see the largest Medicare PDP loss – losing 2 PDP options in 2023.
(2) The average 2023 stand-alone
Medicare Part D premium will increase by 9%.
In late-July,
CMS forecasted a 1.8% decrease in the average basic
Medicare Part D premium. CMS based their
calculation on both stand-alone Medicare Part D PDPs and Medicare Advantage
plans with drug coverage (MAPDs). However, our
preliminary
analysis of only the stand-alone 2023 Medicare
Part D PDPs indicates a
3% premium increase across all PDPs.
(3) As many as 64% of current 2022 Medicare
Part D plan members (not considering LIS eligibility) may have increases in 2023
monthly premiums.
When the 2023
Part D premiums are weighted by current 2022 Part D plan enrollment, we
estimate that up to 64% of all
Medicare Part D beneficiaries currently enrolled in a stand-alone 2022 Medicare
Part D plan will see an increase in their 2023 monthly premium -- unless they
change coverage to a more affordable 2023 Medicare Part D or Medicare Advantage
plan that includes prescription drug coverage (
MAPD).
Learn More: You can
click here to read more in our article about how the average and average enrollment-weighted Medicare Part D plan premiums
have changed since 2007.
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 more low-premium 2023 Medicare Part D
plan options.
Our analysis of the 2023 PDP landscape found
an increase in the number of low-costing PDPs. In 2023, not only will there be more Medicare Part D plan options, but also, about 23% of all stand-alone Medicare Part D plans will have a premium under $25 per month as compared to 19% of the 2022 PDPs with a premium under $25. As an example,
Medicare beneficiaries in Texas will find 37% of stand-alone Medicare Part D plans will have a monthly premium under $25.
In addition, Medicare beneficiaries in
Illinois will find that 33% of all 2023 Medicare Part D plans have premiums under $25. And
New
Mexico residents will find three
(3) more 2023 Medicare Part D plans with premiums under $25
as
compared to 2022 (equating to 25% of all 2023 Part D plans). 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) Highs and Lows: The lowest premium and highest premium stand-alone
2023 Medicare Part D plans.
Oregon and
Washington
State
have the lowest 2023 Part D premium of $1.60 for the SilverScript SmartSaver
(PDP).
Historical
note:
The lowest PDP premium in prior years was back in 2006 (
$1.87 in North Dakota).
In most
other states, the SilverScript SmartSaver (PDP) will have the lowest monthly
premium ranging from $2.80 in
Kansas to $10.90 in
New
York.
The 2023 Medicare Part D plan with the lowest monthly premium - and a
$0 initial deductible -
is the
Arizona
Amerivantage Rx Plus (PDP) plan, with a premium of
$43.80 per month.
The
2023 SilverScript Plus (PDP) and
Wellcare Medicare Rx Value Plus (PDP) are the lowest priced $0 deductible plan in most other states with a premium of about $70.
The 2023 Medicare Part D
plan with the most expensive or highest premium continues to be the
BlueCross Rx Plus (PDP) in
South Carolina at $201.10
per month.
(6) Slightly fewer 2023 Medicare Part D plans qualify for the LIS $0 premium.
There will be a few less 2023 Medicare Part D plans qualifying for the state’s
Low-Income Subsidy (LIS) $0
benchmark premium across the
country.
The state offering the smallest selection of $0 premium LIS plans is
New York, with only three $0 premium LIS plans in 2023.
Arizona will continue
to offer the largest number of $0 premium LIS plans (8 plans).
Learn More: You can
click here to read more
in our article 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) 83% of stand-alone 2023 Medicare Part D
plans have an initial deductible.
As was true in 2022, most 2023 Medicare Part D prescription drug plans (PDPs) will have an initial
deductible ranging from $100 to the
2023 standard initial
deductible of $505.
In fact, about 83% of all 2023
stand-alone Medicare Part D PDPs
will have some initial deductible - with the vast majority of these plans having a $505 initial deductible.
As an example, of the
23
plans available in
Florida, only
four 2023 stand-alone Medicare Part D plans will have a $0
initial deductible.
Learn More: You can
click here to see a
chart showing the changes in the total number of Medicare Part D plans offering
a $0 deductible since 2007.
As was also true
in past years, we are expecting many 2023 Medicare Part D plans that include a
deductible to exclude low-costing drug tiers from the initial deductible.
(8) More 2023 Medicare Part D plans will offer supplemental Donut Hole
coverage.
The
2023 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.
However, about 19% of all stand-alone 2023 Part D plans will 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 2023 Medicare Part D plans
will offer insulin at a $35 (or less) co-pay.
Based on the newly-passed
Inflation Reduction Act, all 2023 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 co-pay of $35 (or less) through all
phases of Part D coverage (with insulin costs possibility reduced further in
the Catastrophic Coverage phase).
This new low-cost insulin provision is similar to the current Medicare
Part D Senior Savings Model where 2021 and
2022 Medicare Part D plans had the option to offer select forms of insulin on
the plan's formulary for a co-pay of $35 or less.
(10) All 2023 Medicare Part D plans
will offer Part D vaccines at a $0 co-pay.
Also based on the
Inflation Reduction Act, all 2023 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.
Important: As noted, the recently enacted Inflation Reduction Act (IRA) will provide for a $35 or less co-pay
for all insulin covered by a Medicare drug plan and a $0 co-pay for all approved Medicare Part D vaccines. But unfortunately, the IRA
was passed AFTER the Medicare drug plans had submitted their 2023 plan details for government approval. This means that the Medicare.gov Plan Finder website (and any other online system)
may not accurately show the cost of insulin or vaccines at this time – so as you look at 2023 drug plan costs, please consider that the cost of your insulin and vaccines may not be accurately displayed.
(11) Remember, all Medicare plans change each year.
You can review changes in Medicare plan features from 2022 to 2023 using our
PDP-Compare.com/2023 or
MA-Compare.com/2023.
- Your formulary (drug list) will change year-to-year, see
FormularyBrowser.com/2023 (updated as data is available)
- The 2023 standard deductible is increasing to $505, see
PDP-Finder.com/2023 or
MA-Finder.com/2023
- The 2023 initial coverage limit (Donut Hole entry) is increasing to $4,660
- The 2023 Total Out-of-Pocket (TrOOP) threshold is increasing to $7,400
Learn More: You can
click here to read our article on the changes in the 2023 standard defined Medicare Part D coverage.
(12) Your Medicare Part A & Part B premiums and deductibles are changing in 2023.
Medicare recently announced that both the Medicare Part B premium and deductible would decrease in 2023. Likewise, Medicare Part B
IRMAA paid by higher-earning Medicare beneficiaries would decrease slightly. However, the 2023 Medicare Part A deductible, cost-sharing, and the 2023 Part A premium will increase slightly.
Learn More: You can read more about the 2023 Medicare Part A and Part B changes in our articles:
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 2023
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 2022 Medicare Part D plans are changing in 2023 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 2023 Medicare Part D premium increases and decreases:
Of the
28 Medicare
Part D plans available in Arizona for 2023, 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 2023 Medicare Advantage plans?
The 2023 Medicare Advantage plan landscape summary will be presented in our
next newsletter. A number of 2023 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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