How is your 2017 Medicare plan changing in 2018?

We want to remind you that, if you decide to stay with your current 2017 Medicare plan into 2018, your Medicare plan coverage and costs can (and usually do) change each year - so please take time to know how your current Medicare plan is changing in 2018. What Medicare plan changes can you expect in 2018?

1.2 million 2017 Medicare Advantage plan members will find their Medicare plan is no longer available in 2018. Although a number of areas around the country will experience significant changes in their Medicare Advantage plan landscape, the counties seeing the largest number of terminated 2018 Medicare Advantage plans are found in: Florida New York, and Ohio. For example, fifteen (15) of the 81 Medicare Advantage plans currently available Queens County, New York will no longer offered in 2018. You can to read more in our article about Medicare plans affected by Service Area Reductions.
You may be automatically reassigned to another 2018 Medicare Part D plan. Over 200,000 current members of stand-alone 2017 Medicare Part D plans and Medicare Advantage plans will be automatically “crosswalked” or merged into another Medicare plan in 2018. For example, members of the 2017 First Health Part D Premier (PDP) will be automatically reassigned to the 2018 First Health Part D Value Plus (PDP). You can click here to read more about 2018 Medicare Part D plan mergers or consolidations.
Your monthly 2018 Medicare Part D premium may be increasing. Without changing 2017 stand-alone Medicare Part D plans, over 6 million Medicare beneficiaries will see a monthly 2018 Medicare Part D premium increase of over 20%. The good news is about 7.6 million people will see a 2018 premium decrease of up to -46%. You can click here to see examples of 2017 Medicare Part D plans that are increasing their 2018 premiums.
Your plan’s Initial Deductible (the amount you pay before coverage) may increase. The standard 2018 Medicare Part D deductible will increase to $405, up from the standard 2017 deductible of $400. About 400,000 Medicare beneficiaries are enrolled in 2017 plan that will see an even larger initial deductible increase of up to $115. You can click here to see an example list of Medicare Part D plan’s increasing their 2018 initial deductibles. The good news is that about 1.3 million people will see a decrease in their current initial deductible, with some plans even moving to a $0 deductible in 2018.
Your 2018 Medicare drug plan’s formulary or drug list may cover fewer medications. Although some 2018 Medicare prescription drug plans will be adding more medications, based on our analysis, over 6 million Medicare beneficiaries currently enrolled in a stand-alone Medicare Part D plan will see at least 100 medications removed from their 2018 formulary. But, please remember that a larger Medicare Part D plan formulary does not necessarily mean you will get more of your medications covered. Important: Check to make sure your medications are affordably covered by your chosen 2018 Medicare Part D plan.
Your 2018 Medicare plan’s prescription drug cost-sharing may increase. You will notice that Medicare plans can change fixed co-payments from year-to-year (you now paid $1 for a Tier 1 drug and in 2018 you will pay $3 for the same drug). And some plans change between co-insurance to copayment as a cost-sharing model. You can click here to see an example of how the 2018 EnvisionRxPlus plan will change from co-insurance to a copayment for Tier 1 and 2 generics on their 2018 plan formulary.
Your Medicare prescription drug plan may begin using preferred pharmacies. About 98% of all 2018 stand-alone Medicare prescription drug plans (PDPs) will use different cost-sharing for preferred vs. standard network pharmacies (as compared to 85% in 2017). The SilverScript Choice (PDP), WellCare Classic (PDP), WellCare Extra (PDP), WPS MedicareRx Plan 1, and WPS MedicareRx Plan 2 will begin using preferred network pharmacy pricing in 2018. As an example, the California SilverScript Choice (PDP) will have a co-payment of $3 for a Tier 1 medication at a preferred network pharmacy and, for the same Tier 1 drug, a $7 co-pay when purchased at a standard network pharmacy. You can contact your plan’s Member Service department to find preferred pharmacies in your area.
Some 2018 Medicare Advantage plans will offer a variation on the standard drug plan Initial Coverage Limit of $3,750, with 2018 Initial Coverage Limits ranging from $3,200 to $8,000. You can click here to read more about 2018 Medicare Advantage plans that have an increased or decreased Initial Coverage Limit.
Your 2018 Medicare Part D plan may no longer qualify for your State’s Low-Income Subsidy (LIS) $0 premium. In 2018, most states will have fewer Medicare Part D plans qualifying for the state’s Low-Income Subsidy (LIS) $0 premium. The state offering the smallest selection of $0 premium LIS plans is Florida, with only two $0 premium 2018 LIS plans (down from three qualifying 2017 Part D plans). For more about the decline in the number of LIS $0 premium plans, you can click here for our article comparing LIS plan availability since 2007.
Your Medicare Advantage plan’s provider network may change. During the past several years some Medicare Advantage plan members have found that their healthcare providers were dropped from the plan’s network. Remember, even though you have checked to ensure that your healthcare providers are included in your Medicare Advantage plan's provider network, it is possible that your plan’s network will change during the plan year. Although Medicare has established a Special Enrollment Period (SEP) allowing you to change Medicare plans if your plan makes “significant” mid-year network changes, it is not yet clear when this SEP will be applied.
Your 2018 Medicare Advantage plan’s Medicare Part A and Part B maximum out-of-pocket (MOOP) limit may change. The Medicare Advantage plan MOOP threshold limits how much you will spend on co-payments and co-insurance for in-network, eligible Medicare Part A and Part B coverage. In 2018, fewer Medicare Advantage plans will offer a Medicare Part A and Part B MOOP limit below the $6,700 maximum. You can click here to learn more about the maximum out-of-pocket limits for 2018 Medicare Advantage plans.

And the Bottom Line: If you do not enroll into a new 2018 Medicare Part D plan or Medicare Advantage plan, you will be automatically re-enrolled into your current Medicare Part D or Medicare Advantage plan for 2018 and your 2018 Medicare plan may cost you more money and provide different coverage than in 2017. If your 2017 Medicare plan is being terminated in 2018 and you are not merged or “crosswalked” to another 2018 Medicare plan, you may be without Medicare plan coverage on January 1st.

The Good News: You still have plenty of time to review your 2018 Medicare plan coverage options during the annual Open Enrollment Period that began on October 15th and continues through December 7th.

How to learn more about the changes in your 2018 Medicare plan?
Your Medicare plan provider is required to summarize any Medicare Part D or Medicare Advantage plan changes in your Annual Notice of Change letter (ANOC) that you should have received in late-September or early-October. If you have not received a copy of your plan’s ANOC letter, please call your plan’s Member Services department and ask your plan to send another copy.

Need a fast way to see how your Medicare Advantage or Medicare Part D plan is changing in 2018?
Our PDP-Compare MA-Compare tools allow you to compare changes in all stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans (MAs or MAPDs) across the country. Our comparison tools show changes in monthly premiums and plan designs, as well as changes in co-payments or co-insurance rates for different drug tiers. Both the PDP-Compare and MA-Compare also show the Medicare Part D plans or Medicare Advantage plans that will be discontinued, merged, or added in 2018. The MA-Compare tool includes links to the health coverage details of all 2017 and 2018 Medicare Advantage plans.