As in past years, some 2021 Medicare Part D plans are changing their cost-sharing designs for 2022 prescription drug purchases.  Cost-sharing is what you will pay for your Medicare Part D formulary drugs and can be either a fixed-copay (Tier 3 drugs are a $47 co-pay) or cost-sharing can be a percentage of the drug's retail cost (25% of retail).  Each year, Medicare drug plans can also change the structure of the plan's formulary or drug list and add - or take away - formulary tiers - or the plan can move drugs from one Tier to another.

Adding new formulary drug tier - For example, the Prescription Blue Select plan will change from a single drug tier for all formulary drugs to a five (5) tier cost-sharing structure in 2022.  In 2022, Prescription Blue Select plan formulary will change as shown in the chart below.

Changing the cost-sharing for a formulary tier - In another example, the 2021 California SilverScript Choice (PDP) plan formulary covers 1,061 medications as Tier Three "Preferred Brand" medications (with a $35 copay).   In 2022, Tier Three "Preferred Brand" will have a 17% coinsurance.

• The changes from a $47 co-pay to a 17% of retail cost-sharing may mean that you are paying less for your Tier 3 medications in 2022. So, if your Tier 3 drugs have a retail price of under $206, you will save money in 2022 with the new 17% cost-sharing.
• You will pay slightly less for your Tier 4 and 5 medications in 2022.

How many people will be affected by these 2021/2022 plan changes?

There are approximately 3,455,120 members in the 2021 SilverScript Choice (PDP) who will see similar changes in their plan coverage.

In total, 3.6 million members of various stand-alone Medicare Part D plans will see one or more of the drug tiers change cost-sharing from either coinsurance (such as 15%) to copay (such as $35) or copay to coinsurance.

To compare annual changes in Medicare plans, our PDP-Compare and MA-Compare tools show the 2022 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 or discontinued and new plans being added in 2022.

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 2022 Medicare Part D or Medicare Advantage plan options.