Whether you are enrolled in traditional Medicare or a Medicare Advantage plan, Medicare covers your prescription drugs under Medicare Part D. The vast majority of people with Medicare, 48 million in 2021, are enrolled in a Part D drug plan. Here’s what you need to know about Medicare Part D coverage and costs in 2022.
Don’t assume that your Part D drug plan will cover your drugs in 2022, even if they did so in 2021. Rather, assume that your costs will go up a lot if you don’t change Part D plans. Each year, these private insurance plans can change dramatically. Kaiser Family Foundation reports on your options.
Red Alert: Nearly three in four people enrolled in traditional Medicare and a Part D plan will pay higher costs if they do not switch plans in 2022.
There are 16 national Part D prescription drug plans, with monthly premiums ranging from $7 to $99. SilverScript SmartRx is offering a Part D plan with a $7 monthly premium. AARP MedicareRx Preferred is offering a Part D plan with a $99 monthly premium. Wellcare Value Script has lowered its Part D monthly premium for 2022 from $16 to $12 a month.
Premiums are typically higher for Part D plans offering enhanced benefits, lower insulin costs, lower cost-sharing and/or low or no deductibles. For example, Part D plans that charge no deductible will have an average monthly premium of $90.
If you have traditional Medicare, you typically will be able to choose among 23 Part D drug plans. The average monthly premium is $43; for standard Part D plans, the average monthly premium is $35, and for enhanced plans it’s $51. Most people (seven in ten) will have an annual deductible of $480, but the average is $384.
Cost-sharing for brand name drugs could be as high as 40-50 percent and as low as $0 for preferred generics, depending upon the Part D plan you choose. Preferred brand copays will average $42.
If you are in a Medicare Advantage plan, you typically will have a choice of 31 Part D drug plans.
If you qualify for a low-income subsidy or LIS, there are 198 Part D drug plans for which you will not pay a premium.
Fewer companies are offering Part D drug plans than ever before, which is largely a result of consolidation in the industry. In 2010, 40 companies offered Part D drug plans. In 2022, 16 companies are offering these plans. Four companies control 80 percent of the market, CVS Health, Centene, UnitedHealth and Humana.
If you need insulin, no matter what state you live in, you can enroll in an Innovation Center Part D plan to lower your insulin costs. You would have a monthly copayment for your insulin of $35 in all phases of Part D coverage. This option is available to everyone who is not eligible for a low-income subsidy or LIS.
If your income is low and you are among the 13 million people with Medicare who qualify for a low-income subsidy, you have a choice of some premium-free Part D stand-alone plans in 2022. You can also choose a “non-benchmark” plan and pay a portion of the monthly premium.
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