In 2017, the standard or model Medicare Part D plan includes a $400 initial deductible (as compared to the standard $360 initial deductible in 2016 Medicare Part D plans) and most stand-alone 2017 Medicare Part D prescription drug plans (PDPs) will have an initial deductible - ranging from $50 to $400.
In fact, according to our calculations, only 38% of all 2017 stand-alone Medicare Part D plans will offer a $0 initial deductible (as compared to 60% of PDPs that had a $0 deductible back in 2007).**
You can see our PDP-Facts.com/2017 for Medicare Part D premium information in your state.
Here is a chart showing the changes of Medicare Part D plan designs since 2007 with fewer Medicare Part D plans now offering a $0 initial deductible.
How many stand-alone 2017 Medicare Part D plans will have the $400 standard Initial Deductible?
Approximately 48%
of all 2017 stand-alone Medicare Part D plans (356 of the 746 PDPs) will have a $400 initial
deductible (or more specifically, of all the 2017 PDPs having an initial
deductible, 77% will have the standard deductible of $400). In comparison, approximately 53%
of all 2016 stand-alone Medicare Part D plans (468 of the 886 PDPs) have a $360 initial
deductible (or again, more specifically, of all the 2016 PDPs having an initial
deductible, 79% will have the standard deductible of $360).**
** Please note that we are not considering Medicare Part D prescription drug plans (PDPs) in U.S. Territories or Puerto Rico.
As was true in 2016, a number of stand-alone 2017 Medicare Part D plans having an initial deductible will exclude some of their formulary tiers from the initial deductible and provide immediate coverage for these drugs, even though the initial deductible is not met.
Editorial Comment: This is a definite bonus for people using mostly low-costing generic medications and who usually did not meet their initial deductible until almost the end of the plan year. Now these people will have "first dollar coverage" for their low-costing medications, plus the Part D coverage protection should they need any expensive brand or specialty medications costing well beyond the deductible.
For example, the 2017 Humana Walmart Rx Plan will have a $400 initial deductible with some of the generic formulary medications excluded from the $400 deductible.
How does this work? This means that, if you were still within your $400 initial deductible and purchase a medication such as Atorvastatin Calcium (generic Lipitor (r)), you would not pay full retail price, but would instead be charged only a copayment for this generic medication (when purchased at one of the Medicare Part D plan's preferred network pharmacy -- such as a Walmart pharmacy). And as always, if your Medicare Part D plan's cost-sharing is more than your drug's retail price, then you pay the lesser retail price (you never pay more than your negotiated retail price).
Reminder: Your Medicare plan costs and coverage can (and probably will) change each year.
If you are interested in changing your Medicare plan enrollment, the annual Open Enrollment Period (or Annual Election Period) for Medicare Advantage plans and Medicare Part D drug plans begins on October 15 and continues through December 7, 2016.
Not sure where to begin?
If you or another Medicare beneficiary needs assistance understanding how your 2016 Medicare plan is changing or to learn more about your 2017 Medicare plan coverage options, please call 1-800-MEDICARE (1-800-633-4227) and speak with a Medicare representative.