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
(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:
- Part A premium and deductible since 2007.
- Part B premium and deductible since 2007.
- Read more about IRMAA changes over the years in our article, Slight decrease in Medicare Part D IRMAA payments along with changes in the IRMAA brackets due to annual inflation adjustments.
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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