Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community
  • Menu ☰
  • Home
  • Contact
  • MAPD
  • PDP
  • 2022
  • 2021
  • FAQs
  • Articles
  • Search
  • Contact
  • 2022
  • 2021
  • FAQs
  • Articles
  • Latest Medicare News
  • Search


2022 Medicare Part D plan outlook: Fewer 2022 Medicare Part D PDP options and most people in 2021 plans may pay higher 2022 Part D premiums

Category: Annual Medicare Plan Changes
Published on 2021-10-03 09:26:00


An initial review of the stand-alone 2022 Medicare Part D prescription drug plans (PDPs), recently released by the Centers for Medicare and Medicaid Services (CMS), shows that Medicare beneficiaries will have fewer 2022 Medicare Part D PDP options and most current plan members will pay higher 2022 monthly PDP premiums (unless they enroll in a lower-premium 2022 Medicare Part D or Medicare Advantage plan).

Here are more highlights of the 2022 stand-alone Medicare Part D landscape from our PDP-Facts.com analysis:

(1) There will be fewer 2022 stand-alone Medicare Part D plan options.

The total number of stand-alone 2022 Medicare Part D prescription drug plans across the country will decrease 23% to 766 plans from 996 plans currently offered in 2021 -- a loss of 230 plans. The average number of 2022 Part D plans offered in each state is decreasing to 23 plans down from 29 plans per state in 2021.

Arizona will offer the most stand-alone 2022 Medicare Part D plan choices (27), down from 32 plans offered in 2021.

In 2022, New York will offer only 19 Medicare Part D plans, down from 28 plans currently offered in 2021. Texas and Georgia will also see the loss of 9 PDP options in 2022.

You can click here to read more about plan availability and see how the total number of stand-alone Medicare Part D plans has changed since 2007.


(2) The average 2022 stand-alone Medicare Part D premium will increase.

In late-July, CMS forecasted a 4.9% increase 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). Our preliminary analysis of only the stand-alone 2022 Medicare Part D PDPs indicates a 15% premium increase across all PDPs.


(3) As many as 84% of current 2021 Medicare Part D plan members (not considering LIS eligibility) may have increases in 2022 monthly premiums.

When the 2022 Part D premiums are weighted by current 2021 Part D plan enrollment, we estimate that up to 84% of all Medicare Part D beneficiaries currently enrolled in a stand-alone 2021 Medicare Part D plan will see an increase in their 2022 monthly premium -- unless they change coverage to a more affordable 2022 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.

Important: 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 fewer low-premium 2022 Medicare Part D plan options.

In contrast to past years, not only will you see fewer stand-alone 2022 Medicare Part D plans, our analysis of the 2022 PDP landscape also found a significant decrease in the number of PDPs with a premium under $25. For example, Medicare beneficiaries in Nevada will find eleven (11) fewer 2022 Medicare Part D plans with premiums under $25 as compared to 2021. In addition, Georgia and Ohio will have nine (9) fewer Part D plans with a premium under $25.


(5) The lowest and highest premium stand-alone Medicare Part D plans

The Colorado Wellcare Value Script (PDP) will have the lowest 2022 Part D premium of $5.50. In all other states, the SilverScript SmartRx (PDP) will have the lowest monthly premium ranging from $6.40 in Arkansas and Louisiana to $7.80 in Hawaii.

The 2022 Medicare Part D plan with the most expensive premium continues to be the BlueCross Rx Plus (PDP) in South Carolina at $207.20 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.


(6) Fewer 2022 Medicare Part D plans qualify for the LIS $0 premium. 

There will be fewer 2022 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, Alaska, Ohio, and New York, with only four $0 premium LIS plans in 2022. Arizona will offer the largest number of $0 premium LIS plans (9 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.

(7) Slightly fewer stand-alone Medicare Part D plans have a $0 deductible.

As was true in 2021, most 2022 Medicare Part D plans will have an initial deductible ranging from $100 to the 2022 standard initial deductible of $480.  As an example, of the 22 plans available in Florida, only four 2022 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. As was true in past years, we are expecting many 2022 Medicare Part D plans that include a deductible to exclude low-costing drug tiers from the initial deductible.


(8) Fewer 2022 Medicare Part D plans will offer supplemental Donut Hole coverage. 

The 2022 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 11% of all stand-alone 2022 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.


(9) More Medicare Part D plans will offer insulin for a max $35 copay.

Following the Part D Senior Savings Model, more stand-alone Medicare Part D prescription drug plans and Medicare Advantage plans offering drug coverage (MAPDs) will offer different types of insulin for a maximum co-pay of $35 through all phases of Part D coverage: deductible, initial coverage, and the Coverage Gap (Donut Hole). CMS noted that more than 2,100 PDPs and MAPDs will offer lower-costing insulin to plan members in 2022 as compared to 1,600 drug plans in 2021. For example, Arizona will offer 10 plans following the Senior Savings Model and all other states will offer seven or eight plans. These plans show the text “select insulin coverage $35 or less” in our PDP-Finder.com

Need an overview of stand-alone Medicare Part D plans in your area?

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 2022 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.

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 2021 Medicare Part D plans are changing in 2022 for each state, just look for the "Summarized in Plan Text" link on our https://PDP-Facts.com state pages. For example, you can click here to read more about drug plan changes in Arizona, such as:

"Arizona 2022 Medicare Part D premium increases and decreases:
Of the 27 Medicare Part D plans available in Arizona for 2022, 2 plan(s) will lower their premiums and 21 will increase their premiums. Currently, 87.9% of Arizona residents enrolled in a stand-alone Medicare Part D plan are enrolled in one of the 21 plans with a premium increase. The average premium increase for members of these plans will be $7.21 per month."

What about 2022 Medicare Advantage plans?
The 2022 Medicare Advantage plan landscape summary will be presented in our Medicare Advantage plan article. A number of 2022 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).


Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used for any commercial purposes without the express authorization of Q1Group.

Copyright Q1Group LLC, Saint Augustine, Florida (2021)






Medicare Supplements
fill the gaps in your
Original Medicare
1. Enter Your ZIP Code:
» Medicare Supplement FAQs




Ask a Pharmacist*
Have questions about your medication?

» Answers to Your Medication Questions, Free!
Available Monday - Friday
8am to 5pm MST
*A free service included with your no cost drug discount card.




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.