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Q1Group 2019 Medicare PDP Analysis: Over 4.5 million people will see an increase of 20% or more in their 2019 Medicare Part D plan premiums


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Q1Group 2019 Medicare PDP Analysis: Over 4.5 million people will see an increase of 20% or more in their 2019 Medicare Part D plan premiums
Published on 2018-10-19 15:39:28
Category: Annual Medicare Plan Changes


As was true in past years, many 2018 stand-alone Medicare Part D prescription drug plans will be increasing their monthly premiums in 2019.  In fact, based on current Medicare plan enrollment, around 13.2 million Medicare beneficiaries will see their stand-alone 2018 Medicare Part D premiums increase in 2019. 

More specifically, over 4.5 million Medicare beneficiaries currently enrolled in stand-alone 2018 Medicare Part D prescription drug plans (PDPs) will see at least a 20% increase in their monthly premium if they stay enrolled in their current plan into 2019.

Some of the largest 2019 Medicare Part D plan increases are highlighted in the table below:

Highlights of the Larger 2019 stand-alone Medicare Prescription Drug Plan
Premium Increases
2019 Plan Name 2018
Premiums
2019
Premiums
Premium Increase Percent Increase States Members Affected
Blue Cross MedicareRx Basic (PDP) Ranging from
$18.90-$26.40
Ranging from
$30.70-$49.70
up to
$30.80
up to 163% NM IL OK TX 139,002 members will see at least a 31% premium increase. Members in NM will see a 163% premium increase
Humana Walmart Rx Plan (PDP) Ranging from $18.40-$20.40 Ranging from $22.20-35.70 up to $15.30 up to 75% all states 2,287,638 members will see at least a 20% increase in premium
First Health Part D Value Plus (PDP) crosswalked to the Aetna Medicare Rx Value Plus (PDP) $66.70 $114.80 48.10 72% OK 8,183 members
SilverScript Choice (PDP) Ranging from $16.40-$53.30 Ranging from $23.20-$49.50 upto $8.40 upto to 41% 13 states 1,913,372 members in 13 states will see at least a 20% increase

Good News for Some Members:
Approximately 6.2 million Medicare beneficiaries will see a decrease in their 2019 Medicare Part D plan premium.  The largest decrease is the California EnvisionRxPlus plan where the premium will fall from $50.00 in 2018 to $12.90 in 2019.

You can use our PDP-Compare and MA-Compare tools to learn more about how 2018 Medicare Part D and Medicare Advantage plans are changing in 2019.  Our PDP-Compare and MA-Compare show changes in all 2018/2019 stand-alone Medicare Part D prescription drug plans (PDPs) and Medicare Advantage plans (MAs or MAPDs) across the country and include changes in plan features such as premium, deductible, cost-sharing and formulary size changes.

Our Medicare plan compare tools also highlight 2018 plans that will be merged or discontinued in 2019 and new plans that will be added in 2019.

Reminder:  If you are using several brand-name medications or an expensive specialty medication, your monthly Medicare plan premiums may not be a significant part of your annual medication costs.  Be sure to consider the entire cost of your drug coverage when choosing a Medicare plan: premiums, co-payments, co-insurance, Donut Hole coverage, and Catastrophic Coverage.

Not sure whether your 2018 Medicare plan is still the most economical 2019 plan option?
Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about Medicare plan coverage and their 2018 Medicare Part D and Medicare Advantage plan options.


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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.