If your stand-alone Medicare Part D prescription drug plan (PDP
) - or Medicare Advantage plan that includes drug coverage (MAPD) - has an initial deductible, you will usually pay 100% of your prescription drug costs
until you have met the deductible. For example, if your Medicare plan has a $415 deductible, you will pay the retail price for your medications until you have spent $415 and then your plan coverage will begin (and you will only pay a portion of the retail cost, such as a $30 co-pay or 25% co-insurance on your medications).
Reminder about formulary tiers excluded from your deductible:
Many 2019 Medicare Part D plans have certain drug tiers excluded from your initial deductible. For example, you may find that your 2019 Medicare Part D plan has a $415 initial deductible, but the deducible only applies to medications on formulary Tier 3, Tier 4, and Tier 5 - and your lower-costing Tier 1 and Tier 2 drugs are covered before meeting the $415 deductible.
About 8.6 million people will only see a $10 increase in their initial deductible.
The 2019 standard
Medicare Part D prescription drug plan initial
deductible will increase to $415 from the $405 standard
deductible in 2018 and this $10 increase in deductibles will impact about 8,483,051 people currently enrolled in a 2018 stand-alone Medicare Part D plan.
However, over 500,000 people will see an increase in their 2019 initial deductible of $30 or more.
In fact, approximately 571,590 stand-alone Medicare Part D beneficiaries are enrolled in PDP that
will have an initial deductible increase from $30 to $315.
The chart below highlights some of the increases in 2018 / 2019 Medicare Part D plan deductibles.
2018 Medicare Prescription Drug Plan
2019 Plan Name
|SilverScript Choice (PDP)
|BlueCross Rx Value (PDP)
|Blue MedicareRx Value Plus (PDP)
||CT, MA, RI, and VT
||$260 or $270
||$30 or $40
||11% or 15%
The good news: about 1.2 million people will see a decrease in their current initial deductible.
How to see the changes in your 2019 initial deductible.
As in past years
, some stand-alone Medicare Part D plans (PDPs
have chosen to reduce their initial deductible for the 2019 plan year.
Members of the Hawaii SilverScript Choice (PDP) will have a
$0 deductible in 2019. About 1,200,000 members across various Medicare Part D plans will see a decrease of between $5 to $185.
As a note, members of the various Aetna Medicare Rx Saver and Select PDP plans will have varied changes in initial deductible ranging from a $105 decrease
to a $60 increase
tools show the highlight coverage changes for each stand-alone Medicare Part D prescription drug
(PDP) and Medicare Advantage (MA or MAPD) plan across the country and include 2018 / 2019 changes in
plan features such as premium, deductible, cost-sharing and formulary
size changes. Our compare tools also highlight plans that will be merged
and plans that will be added
Not sure whether you want an initial deductible?
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.