Our initial analysis of the 2019 Medicare Part D Plan (PDP) data for prescription drug coverage, released by the Centers for Medicare and Medicaid Services (CMS) on the 29th of September, concludes that:
- Medicare beneficiaries in most states have more PDP options, and;
- Many beneficiaries will experience an overall cost increase unless they choose a 2019 plan with a lower premium and annual deductible.
Here are a few highlights of our analysis:
- More PDPs with lower premiums in most states. 2018 started a trend toward lowering premiums on basic plans. This trend continues in 2019, with new, lower-cost plans for Medicare beneficiaries in California, Colorado, and New Mexico. Beneficiaries in these states have three new Medicare Part D plans with premiums less than $25.
- More PDP choices in 2019. 2018 saw an increase in the number of Medicare Part D plan options, and this trend continues in 2019. The average number of Medicare Part D plans offered across the country is increasing from 23 in 2018 to 26 in 2019. Florida is the biggest winner with six additional options. Most states get between three and five new PDPs. No states will see a reduction in the number of stand-alone Medicare Part D plans in 2019.
- New threshold on the lowest premium. The lowest Part D premium in 2019 is the WellCare Value Script (PDP) in Texas, with a premium of just $10.40. The same national WellCare plan is available in all states with a premium up to $16.90 (Arkansas and Louisiana). In a few states, the EnvisionRxPlus (PDP) plan beats out WellCare Value Script (PDP), with rates between $12.90 and $14.50. In Arizona, the Aetna Medicare Rx Select (PDP) plan offers the lowest monthly premium, $12.20.
- PDP premiums increase for many beneficiaries. Although the weighted national average on Medicare Part D premium will drop by 10% in 2019, the average weighted premium on existing plans is increasing by 2%. We estimate that more than 60 percent of all Medicare beneficiaries enrolled in a 2018 Medicare Part D plan will experience an increase in their 2019 premium. Beneficiaries are highly encouraged to shop and compare plans to find the overall best cost.
- Fewer Part D plans with a $0 annual deductible. Most 2019 Medicare Part D plans have an annual deductible ranging from $15 to the maximum deductible of $415 (up $10 from 2018).
- Fewer PDPs that qualify for the $0 Low-Income Subsidy (LIS) premium. In most states, Medicare beneficiaries have the same or slightly fewer Part D plans that qualify for the state’s benchmark premium. Florida continues to be the state with the fewest $0 premium LIS plans. With two additional pans each, California and Louisiana had the largest increase in LIS qualifying plans.
- Medicare Part D initial coverage limit (ICL) up $70 to $3,820. ICL tracks the retail value of your prescription drug purchases. ICL is what determines when you enter the Coverage Gap phase of your plan.
- The Donut Hole (Coverage Gap) continues to close. The 2019 Coverage Gap discount increases to 75 percent for brand-name drugs (you pay 25% of retail) and a 63 percent for generics (you pay 37% of retail).
- Fewer 2019 Medicare Part D plans will offer additional Donut Hole coverage. About 23% of all stand-alone 2019 Part D plans offer some level of Gap Coverage – in addition to the Donut Hole discount.
- Some 2019 Medicare Part D plans are changing names: As mergers and partnerships continue, so do the plan name changes. So far, we know of just one such change. The First Health Part D Value Plus plan is now the Aetna Medicare Rx Value Plus (PDP) plan.
The 2019 Annual Election Period (AEP) for Medicare Part D plans and Medicare Advantage plans starts Monday, October 15th and continues through Friday, December 7th. Coverage for your new plan elections starts January 1, 2019.
Beginning October 1st, you can call Medicare at 1-800-633-4227 to learn more about your 2019 plan options and make changes or get enrolled.