A non-government resource for the Medicare community
Powered by Q1Group LLC
A non-government Medicare community resource
  • Menu
  • Home
  • Contact
  • MAPD
  • PDP
  • 2024
  • 2025
  • FAQs
  • Articles
  • Search
  • Contact
  • 2024
  • 2025
  • FAQs
  • Articles
  • Latest Medicare News
  • Search

How is your 2017 Medicare plan changing in 2018?

Category: Annual Medicare plan changes
Published: Nov, 02 2017 02:11:35


We want to remind you that, if you decide to stay with your current 2017 Medicare plan into 2018, your Medicare plan coverage and costs can (and usually do) change each year - so please take time to know how your current Medicare plan is changing in 2018. What Medicare plan changes can you expect in 2018?
  • 1.2 million 2017 Medicare Advantage plan members will find their Medicare plan is no longer available in 2018. Although a number of areas around the country will experience significant changes in their Medicare Advantage plan landscape, the counties seeing the largest number of terminated 2018 Medicare Advantage plans are found in: FloridaNew York, and Ohio. For example, fifteen (15) of the 81 Medicare Advantage plans currently available Queens County, New York will no longer offered in 2018. You can to read more in our article about Medicare plans affected by Service Area Reductions.

  • You may be automatically reassigned to another 2018 Medicare Part D plan. Over 200,000 current members of stand-alone 2017 Medicare Part D plans and Medicare Advantage plans will be automatically “crosswalked” or merged into another Medicare plan in 2018. For example, members of the 2017 First Health Part D Premier (PDP) will be automatically reassigned to the 2018 First Health Part D Value Plus (PDP). You can click here to read more about 2018 Medicare Part D plan mergers or consolidations.

  • Your monthly 2018 Medicare Part D premium may be increasing. Without changing 2017 stand-alone Medicare Part D plans, over 6 million Medicare beneficiaries will see a monthly 2018 Medicare Part D premium increase of over 20%. The good news is about 7.6 million people will see a 2018 premium decrease of up to -46%. You can click here to see examples of 2017 Medicare Part D plans that are increasing their 2018 premiums.

  • Your plan’s Initial Deductible (the amount you pay before coverage) may increase. The standard 2018 Medicare Part D deductible will increase to $405, up from the standard 2017 deductible of $400. About 400,000 Medicare beneficiaries are enrolled in 2017 plan that will see an even larger initial deductible increase of up to $115. You can click here to see an example list of Medicare Part D plan’s increasing their 2018 initial deductibles. The good news is that about 1.3 million people will see a decrease in their current initial deductible, with some plans even moving to a $0 deductible in 2018.

  • Your 2018 Medicare drug plan’s formulary or drug list may cover fewer medications. Although some 2018 Medicare prescription drug plans will be adding more medications, based on our analysis, over 6 million Medicare beneficiaries currently enrolled in a stand-alone Medicare Part D plan will see at least 100 medications removed from their 2018 formulary. But, please remember that a larger Medicare Part D plan formulary does not necessarily mean you will get more of your medications covered. Important: Check to make sure your medications are affordably covered by your chosen 2018 Medicare Part D plan.

  • Your 2018 Medicare plan’s prescription drug cost-sharing may increase. You will notice that Medicare plans can change fixed co-payments from year-to-year (you now paid $1 for a Tier 1 drug and in 2018 you will pay $3 for the same drug). And some plans change between co-insurance to copayment as a cost-sharing model. You can click here to see an example of how the 2018 EnvisionRxPlus plan will change from co-insurance to a copayment for Tier 1 and 2 generics on their 2018 plan formulary.

  • Your Medicare prescription drug plan may begin using preferred pharmacies. About 98% of all 2018 stand-alone Medicare prescription drug plans (PDPs) will use different cost-sharing for preferred vs. standard network pharmacies (as compared to 85% in 2017). The SilverScript Choice (PDP), WellCare Classic (PDP), WellCare Extra (PDP), WPS MedicareRx Plan 1, and WPS MedicareRx Plan 2 will begin using preferred network pharmacy pricing in 2018. As an example, the California SilverScript Choice (PDP) will have a co-payment of $3 for a Tier 1 medication at a preferred network pharmacy and, for the same Tier 1 drug, a $7 co-pay when purchased at a standard network pharmacy. You can contact your plan’s Member Service department to find preferred pharmacies in your area.

  • Some 2018 Medicare Advantage plans will offer a variation on the standard drug plan Initial Coverage Limit of $3,750, with 2018 Initial Coverage Limits ranging from $3,200 to $8,000. You can click here to read more about 2018 Medicare Advantage plans that have an increased or decreased Initial Coverage Limit.

  • Your 2018 Medicare Part D plan may no longer qualify for your State’s Low-Income Subsidy (LIS) $0 premium. In 2018, most states will have fewer Medicare Part D plans qualifying for the state’s Low-Income Subsidy (LIS) $0 premium. The state offering the smallest selection of $0 premium LIS plans is Florida, with only two $0 premium 2018 LIS plans (down from three qualifying 2017 Part D plans). For more about the decline in the number of LIS $0 premium plans, you can click here for our article comparing LIS plan availability since 2007.

  • Your Medicare Advantage plan’s provider network may change. During the past several years some Medicare Advantage plan members have found that their healthcare providers were dropped from the plan’s network. Remember, even though you have checked to ensure that your healthcare providers are included in your Medicare Advantage plan's provider network, it is possible that your plan’s network will change during the plan year. Although Medicare has established a Special Enrollment Period (SEP) allowing you to change Medicare plans if your plan makes “significant” mid-year network changes, it is not yet clear when this SEP will be applied.

  • Your 2018 Medicare Advantage plan’s Medicare Part A and Part B maximum out-of-pocket (MOOP) limit may change. The Medicare Advantage plan MOOP threshold limits how much you will spend on co-payments and co-insurance for in-network, eligible Medicare Part A and Part B coverage. In 2018, fewer Medicare Advantage plans will offer a Medicare Part A and Part B MOOP limit below the $6,700 maximum. You can click here to learn more about the maximum out-of-pocket limits for 2018 Medicare Advantage plans.
And the Bottom Line: If you do not enroll into a new 2018 Medicare Part D plan or Medicare Advantage plan, you will be automatically re-enrolled into your current Medicare Part D or Medicare Advantage plan for 2018 and your 2018 Medicare plan may cost you more money and provide different coverage than in 2017. If your 2017 Medicare plan is being terminated in 2018 and you are not merged or “crosswalked” to another 2018 Medicare plan, you may be without Medicare plan coverage on January 1st.

The Good News: You still have plenty of time to review your 2018 Medicare plan coverage options during the annual Open Enrollment Period that began on October 15th and continues through December 7th.

How to learn more about the changes in your 2018 Medicare plan?
Your Medicare plan provider is required to summarize any Medicare Part D or Medicare Advantage plan changes in your Annual Notice of Change letter (ANOC) that you should have received in late-September or early-October. If you have not received a copy of your plan’s ANOC letter, please call your plan’s Member Services department and ask your plan to send another copy.

Need a fast way to see how your Medicare Advantage or Medicare Part D plan is changing in 2018?
Our PDP-CompareMA-Compare tools allow you to compare changes in all stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans (MAs or MAPDs) across the country. Our comparison tools show changes in monthly premiums and plan designs, as well as changes in co-payments or co-insurance rates for different drug tiers. Both the PDP-Compare and MA-Compare also show the Medicare Part D plans or Medicare Advantage plans that will be discontinued, merged, or added in 2018. The MA-Compare tool includes links to the health coverage details of all 2017 and 2018 Medicare Advantage plans.






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




Pets are Family Too!
Use your drug discount card to save on medications for the entire family ‐ including your pets.

  • No enrollment fee and no limits on usage
  • Everyone in your household can use the same card, including your pets
Your drug discount card is available to you at no cost.




Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • 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 PDPCompare.com and MACompare.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.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • 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.