(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
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
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.