22 Best Medicare Part D Plans in Delaware for 2023

We found the 22 best Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... Plans in Delaware for 2023.

We also ranked the best Medicare Advantage plans with Part D in Delaware for 2023.

Delaware Medicare Part D Plans Have Four Phases

Part D prescription drug plans help Delaware's Medicare beneficiaries pay for their prescriptions. If you're new to Medicare, you may not be familiar with how Medicare Part D out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. work. So, let's start with the four cost-sharing phases.

The Deductible is the First Phase

Prior to a plan paying any of your prescription costs, you are required to pay the annual deductible. So, if you enroll in a 2023 plan with a $400 deductible, you'll spend $400 out-of-pocket before coverage begins. Most Medicare Part D plans have a deductible, but some plans exclude Tier 1 (generics), offering immediate coverage on low-cost medications.

NOTE: $505 is the maximum deductible a plan can have in 2023.

The 2nd Phase is the Initial Coverage Limit (ICL)

For 2023, the Part D Initial Coverage Limit (ICL) is $4,660. Your Part D plan will pay the bulk of your prescription cost during the ICL phase. If your costs exceed $4,660, then you will be in the coverage gap phase (aka "doughnut hole")

The Coverage Gap is the Third Phase

After your gross drug costs have reached $4,660, you will enter the Coverage GapA period of time in which you pay higher cost-sharing for prescription drugs until you spend enough to qualify for catastrophic coverage. phase. This is where you will pay 25% of your medication's retail cost. While the price of generic drugsA generic drug is a prescription medication that has the same active ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs. might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,400 in True Out Of Pocket Costs (TrOOP).

Some plans offer additional gap coverage, so look for it on the plan information pages.

Catastrophic Coverage is the Fourth Phase

All Part D plans offer catastrophic coverage once you have paid $7,400 in true out-of-pocket costs for covered drugs. This amount includes the cost of covered drugs as well as some additional costs. In the catastrophic coverage phase, your copaysA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. or coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service.  will be significantly lower for the remainder of the year.

The out-of-pocket costs that help you get catastrophic coverage include:

1. Your plan's deductible;
2. What you paid during the initial coverage limitOnce you have met your yearly deductible, you will pay a copayment or coinsurance for each covered drug until you reach the initial coverage limit. You will then enter your plan’s coverage gap (aka, “donut... period;
3. Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
4. The amount paid by others, including family members, most charities, and other persons on your behalf; and
5. The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.

Choose Your Part D Plan Wisely

Don't make a decision on your choice of Part D Medicare plans based on the premium and deductible alone. It's critical that you verify that your medications are covered. You find this information, and the co-payment tiers, in the formularyA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan's formulary are generally not covered.. On each PDP page (above) we post links to the formulary and pharmacy web pages, and the phone numbers to contact the plan.

CRITICAL: The best Medicare Part D Plans for you can only be determined by factoring in what you can afford, your regular prescriptions, and your health. A bit of time spent on research will pay off in the long run.

Medicare Part D is Included in Most Medicare Advantage Plans

Your Medicare benefits are flexible, and there's more than one way to get prescription drug coverage. If you want to keep your Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., you can enroll in one of the stand-alone prescription drug plans available in Delaware. The other way to get Part D coverage is to enroll in one of the many Medicare Advantage Plans available in Delaware that include Part D benefits.

Medicare Part D and Medicare Supplements Work Together

Medicare does not pay for all of your hospitalization and medical bills. In fact, Original Medicare only covers about 80 percent of your major medical costs. We keep an up-to-date directory of Delaware Medigap Plans, also called Medicare SupplementsMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage., with the tools you need to find the best price and coverage. Medicare Part D plans are fully compatible with Delaware Medigap plans.

Medicare Part D for Dual Eligible People in Delaware

In Delaware, if you are eligible for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") you will automatically be enrolled in a Delaware Medicare Prescription Drug Plan and the Social Security Extra Help program. Extra Help pays for most of the costs of your prescriptions if you meet the eligibility requirements. You may also enroll in a plan of your own choosing that better meets your needs. If you qualified for MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. before you were eligible for Medicare, contact your local Medicaid office.

Citations & References

1. Medicare.gov, "How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan", Last Accessed September 28, 2022
2. Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed September 1, 2022
3. Medicare.gov, "Catastrophic coverage", Last Accessed June 13, 2022
4. Medicare.gov, "Are prescription drugs covered in Medicare Advantage plans?", Last Accessed June 6, 2022
5. SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
6. CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
7. CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023

This Medicare Part D plan state information page was last updated on January 19, 2023.