Best Medicare Part D Plans for New Mexico Beneficiaries in 2024

We found the 24 best Medicare Part D Plans in New Mexico. Sign-up for 2024 Medicare Part D plan notification HERE.

We also ranked the best Medicare Advantage plans with Part D in New Mexico for 2024.

Every Part D Plan in New Mexico Has 4 Cost Phases

Medicare prescription drug plans are designed to help Medicare beneficiaries pay for their prescription drugs. Some of the cost-sharing concepts of these plans are foreign to new Medicare beneficiaries, so let's look at the four phases.

The Deductible is the First Phase

A Medicare Part D plan's deductible is the amount you pay out-of-pocket before the initial coverage phase begins and the plan begins paying its share. So, if you enroll in a plan with a $225 deductible, you'll spend that much at the pharmacy for your prescriptions. After that amount, you will pay the copay amount only until you reach the coverage gap. Most Medicare prescription drug plans have a deductible, however, many plans exclude Tier 1 drugs from the deductible, which gives you first-dollar coverage on most lower-cost medications.

NOTE: The maximum Part D plan deductible in 2023 is $505.

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")

Phase 3 is the Coverage Gap

After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic 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.

The Fourth Phase is Catastrophic Coverage

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 copays or coinsurance 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 limit 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 with Care

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 formulary. On each PDP page (above) we post links to the formulary and pharmacy web pages, and the phone numbers to contact the plan.

VITAL: Identifying the best Medicare Part D Plans requires research. What works the best for you is all about your regular prescriptions (if any), your health, and what you can afford.

Did you Know Most Medicare Advantage Plans Include Prescription Benefits?

Your Medicare benefits are flexible, and there's more than one way to get prescription drug coverage. If you want to keep your Original Medicare, you can enroll in one of the stand-alone prescription drug plans available in New Mexico. The other way to get Part D coverage is to enroll in one of the many Medicare Advantage Plans available in New Mexico that include Part D benefits.

Combining a Medicare Supplement and Medicare Part D Benefits

Are you thinking about supplemental Medicare insurance that can offer you more coverage? It's a smart move. Original Medicare only covers about 80 percent of your major medical bills, leaving you to cover the rest. We make it easy to find the lowest rates on New Mexico Medicare Supplements, also known as Medigap plans. The choice is yours because all Part D plans are compatible with the full range of New Mexico Medicare Supplements.

Getting Medicare Part D with New Mexico Medicaid

In New Mexico, if you are eligible for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") you will automatically be enrolled in a New Mexico 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 Medicaid before you were eligible for Medicare, contact your local Medicaid office.

Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.

Citations & References

1. Medicare.gov, "How to get prescription drug coverage", Last Accessed September 3, 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, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed June 7, 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