Here are more highlights of the 2021 stand-alone Medicare Part D landscape from our PDP-Facts.com analysis:
(1) More 2021 stand-alone Medicare Part D plan options in most states.
The total number of stand-alone 2021 Medicare Part D
plans will increase across the country with the average number of 2021 Part D
plans per state increasing to 29
plans.
Texas
will have the largest gain of PDPs with five (5) additional plan
choices and most other states will have one to four (4) additional PDP options. Seven (7) states will have no change and eight (8) states will have one less PDP option in 2021.
You can click
here to read more about plan availability and see a chart of how the average number of
stand-alone Medicare Part D plans has changed since 2007.
(2) Some 2021 Medicare Part D plans are changing names or carriers.
As in past years, some 2021 stand-alone Medicare Part D plans in your state
may be changing their name or even their plan carriers (with changes in cost
and coverage).
In fact, our analysis shows that over 2.7 million people currently enrolled in a
2020 plan will find their plan’s name changing in 2021.
Some examples of plan changes are: the 2020
EnvisionRxSecure PDP will become the 2021 Elixir RxSecure Plan. The 2020
EnvisionRxPlus (PDP) plan will become the 2021 Elixir RxPlus (PDP)
in 31 states and the 2021
Elixir RxSecure (PDP) in 23 states. You can see more Medicare Part D plan changes using our 2020/2021
PDP-Compare tool. Here is an example
showing California Part D plan changes: PDP-Compare.com/2021/CA.
(3) The average 2021 stand-alone Medicare Part D premium will increase.
In late-July, CMS
forecasted a slight-increase in the Part D combined (PDP & MAPD) average
premium, and our analysis of
the 2021 stand-alone Medicare Part D plans (PDP-only) supports the CMS
forecast. Based on available
information, we expect a 1% increase in the average PDP
premium from $40.90 in 2020 to $41.38 in 2021.
(4) 67%* of current 2020 Medicare Part D plan members may have increases in
2021 monthly premiums.
When the 2021 Part D premiums are weighted by
current 2020 Part D plan enrollment, the weighted average Medicare Part D plan
premium will increase 8% to $40.70.
This means, based on 2021 PDP premium increases and current 2020 plan
enrollment, around 67%* of all
Medicare Part D beneficiaries currently enrolled in a stand-alone 2020 Medicare
Part D plan will see an increase in their 2021 monthly premium* -- unless they
change coverage to a more affordable 2021 Medicare Part D or Medicare Advantage
plan that includes prescription drug coverage (MAPD). You
can click
here to view a chart of how the average and average weighted Medicare Part D plan
premiums have changed since 2007. (* not considering Low-Income Subsidy eligibility)
(5) Slightly more lower-premium 2021 Medicare Part D plan options.
Not only will you see more
stand-alone 2021 Medicare Part D plans, our analysis of the 2021 PDP landscape
also found a slight increase in the number of PDPs with a premium under
$25. For example, Medicare beneficiaries in Ohio
will find four (4) additional 2021 Medicare Part D plans with premiums under
$25 as
compared to 2020.
(6) The lowest and highest premium stand-alone Medicare Part D plans
The Hawaii SilverScript
SmartRx (PDP) will have the lowest 2021 Part D premium of $5.70. In all other states, the
SilverScript SmartRx (PDP) will have the lowest
monthly premium ranging from $6.20 in New
Mexico to $7.80 in Oklahoma.
The 2021 Medicare Part D
plan with the most expensive premium continues to be the BlueCross Rx Plus (PDP) in South
Carolina at
$205.30 per month. You can click
here to
read more about the Medicare Part D plans with the lowest and highest premiums
and how the range of premiums has changed since 2007.
(7) More 2021 Medicare Part D plans qualifying for the LIS $0 premium
There will be slightly more 2021 Medicare Part D plans qualifying for the
state’s Low-Income
Subsidy
(LIS) $0 benchmark
premium across the country.
The states offering the smallest selection of $0 premium LIS PDPs are Florida, Hawaii, Ohio,
and South Carolina, with only five $0 premium LIS plans in 2021. Arizona, Illinois,
Pennsylvania, and West Virginia will offer the largest number of $0 premium LIS
plans (10 plans). You can click
here to read more 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.
(8) Slightly more stand-alone Medicare Part D plans with a $0 initial deductible
As was true in 2020, most 2021 Medicare Part D plans will have an initial
deductible ranging from $100 to the 2021
standard initial deductible of $445. As an example, of the 28
plans available in Florida,
only four
2021 stand-alone Medicare Part D plans will have a $0 initial deductible. 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.
(9) Yes, the Donut Hole is “closed”, but you still may pay more for your
drugs in the 2021 Donut Hole.
The 2021
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. Remember, although the Donut Hole closed in
2020, this phase of your Medicare Part D coverage did
not go away
and you may
pay more
for your medications if you enter the Donut Hole. You can click
here to
read more on the 2021 Donut Hole.
(10) Fewer 2021 Medicare Part D plans will offer supplemental Donut Hole
coverage.
About 13% of all stand-alone 2021 Part D plans 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.
(11) About 31% of all 2021 Medicare Part D plans will offer low-cost Insulin
coverage.
As part of the new CMS "Part D Senior Savings Model", 31% of all 2021
Medicare prescription drug plans across the country will offer different types
of insulin at a maximum co-pay of $35 per month throughout all phases of your
drug coverage: deductible, initial coverage, and the Coverage Gap (Donut Hole).
Alabama, Florida,
Pennsylvania, Tennessee,
and West Virginia will offer 10 plans following the Senior
Savings Model and all other states will offer nine (9) plans. These plans show the text “insulin
coverage $35 or less” in our PDPFinder.com. You can
click
here to
learn more about low co-pay insulin coverage.
If you would like to see a specific state’s PDP landscape summary, please use the following links to our interactive 2021 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 (or PDPs) – and does not include the U.S. territories.
The 2021 Medicare Advantage plan landscape summary will be presented in our next newsletter.
A number of 2021 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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