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
(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
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
down from 29 plans per state in 2021.
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
will also see the loss of
9 PDP options in 2022.
You can click here
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.
late-July, CMS forecasted
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
only the stand-alone 2022 Medicare Part D PDPs indicates a 15% premium
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
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
view a chart of how the average and average weighted Medicare Part D plan
premiums have changed since 2007.
: 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
from Medicare in early-November, informing you about your upcoming premium
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
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
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
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
$207.20 per month.
You can click
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
(LIS) $0 benchmark
across the country.
The states offering the smallest selection of $0 premium LIS PDPs are Florida
and New York
, with only four $0 premium LIS plans in
will offer the largest number of $0 premium LIS
plans (9 plans).
You can click
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
(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
available in Florida
, only four
2022 stand-alone Medicare Part D plans will
have a $0 initial deductible.
You can click
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
(8) Fewer 2022 Medicare Part D plans will offer supplemental Donut Hole
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
However, about 11% of all stand-alone 2022 Part D plans offer some level of additional
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
Medicare Part D plans will offer insulin for a max $35 copay.
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?
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
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
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
) 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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