If your stand-alone Medicare Part D prescription drug plan (PDP) - or Medicare Advantage plan that includes drug coverage (MAPD) - has an initial deductible, you will usually pay 100% of your prescription drug costs until you have met the deductible.  For example, if your Medicare plan has a $415 deductible, you will pay the retail price for your medications until you have spent $415 and then your plan coverage will begin (and you will only pay a portion of the retail cost, such as a $30 co-pay or 25% co-insurance on your medications).

Reminder about formulary tiers excluded from your deductible:
Many 2019 Medicare Part D plans have certain drug tiers excluded from your initial deductible.  For example, you may find that your 2019 Medicare Part D plan has a $415 initial deductible, but the deductible only applies to medications on formulary Tier 3, Tier 4, and Tier 5 - and your lower-costing Tier 1 and Tier 2 drugs are covered before meeting the $415 deductible.

About 8.6 million people will only see a $10 increase in their initial deductible.

The 2019 standard Medicare Part D prescription drug plan initial deductible will increase to $415 from the $405 standard deductible in 2018 and this $10 increase in deductibles will impact about 8,483,051 people currently enrolled in a 2018 stand-alone Medicare Part D plan.

However, over 500,000 people will see an increase in their 2019 initial deductible of $30 or more.
In fact, approximately 571,590 stand-alone Medicare Part D beneficiaries are enrolled in PDP that will have an initial deductible increase from $30 to $315.

The chart below highlights some of the increases in 2018 / 2019 Medicare Part D plan deductibles.

As in past years, some stand-alone Medicare Part D plans (PDPs) have chosen to reduce their initial deductible for the 2019 plan year. Members of the Hawaii SilverScript Choice (PDP) will  have a $0 deductible in 2019. About 1,200,000 members across various Medicare Part D plans will see a decrease of between $5 to $185.

As a note, members of the various Aetna Medicare Rx Saver and Select PDP plans will have varied changes in initial deductible ranging from a $105 decrease in WI to a $60 increase in AK and NM.