As in past years, some 2017 Medicare Part D plans are
changing their cost-sharing designs for 2018 prescription drug purchases. For example, the EnvisionRxPlus (PDP) plan in many states will change their generic drug tiers from co-insurance (a percentage of the drug cost) to copay (a flat fee) in 2018.
As can be seen in the following example, the 2017 EnvisionRxPlus plan formulary covers 312 medications as Tier One "Generic" medications (with an 10% co-insurance).
In comparison, the 2018 EnvisionRxPlus plan formulary covers 124 medications as Tier One "Preferred Generics" (with an $1 co-pay) and 573 drugs as Tier Two "Generics" (with an $3 co-pay).
Illinois EnvisionRxPlus
2017 and 2018 Medicare Part D plan Cost-sharing Comparison
|
|
2017 |
2018 |
Monthly Premium |
$29.00 |
$26.80 |
Initial Deductible |
$400 |
$405 |
Gap Coverage |
No Gap Coverage |
No Gap Coverage |
Tier |
2017
Cost-Sharing |
Drugs
on Tier |
Tier |
2018
Cost-Sharing |
Drugs
on Tier |
1 |
Preferred Generic
|
10%
|
312
|
1 |
Preferred Generic |
$1
|
124
|
2 |
Generic |
12% |
532 |
2 |
Generic |
$3 |
573 |
3 |
Preferred Brand |
15% |
259 |
3 |
Preferred Brand |
15% |
392 |
4 |
Non-Preferred Drug |
33% |
1,539 |
4 |
Non-Preferred Drug |
30% |
1,076 |
5 |
Specialty Tier |
25% |
565 |
5 |
Specialty Tier |
15% |
515
|
Total Formulary Drugs
|
Browse 2017 Formulary |
3,207 |
|
Browse 2018
Formulary |
3,015 |
There are approximately
94,485 members in the 2017 EnvisionRxPlus plan who will see this change. Members in the
Mississippi EnvisionRxPlus will see their cost-sharing Tier 2 Generics change to a $6 copay.
An additional
250,021 members in the 2017
EnvisionRxPlus (ex: PA) plan will see their Tier 3 Preferred Brand cost-sharing change from 10% co-insurance to a copay of $29 ($34 in
Oregon and
Washington State).
In total,
808,765 members of various stand-alone Medicare Part D plans will see one or more of the drug tiers change cost-sharing from either coinsurance to copay or copay to coinsurance.
To compare annual changes in Medicare plans, our
PDP-Compare
and
MA-Compare
tools show the 2017 stand-alone Medicare Part D prescription drug plans
(PDPs) and Medicare Advantage plans (MAs or MAPDs) across the country and include changes in
plan features such as premium, deductible, cost-sharing and formulary
size changes. Our compare tools also highlight plans that will be merged, discontinued, or added in 2018.
Not sure where to begin with choosing your Medicare Part D plan?
Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak
with a Medicare representative, and learn more about their 2018 Medicare
Part D or Medicare Advantage plan options.