Some of the best news providing financial relief to Medicare beneficiaries was the recent passing of the Inflation Reduction Act. Although the IRA (Inflation Reduction Act) does not have a direct impact on new 2023 Medicare Part D Plans, it does eliminate cost sharing for adult vaccines covered under Part D. It also required drug companies to pay rebates if drug prices rise higher than inflation.
What we also know about the Inflation Reduction Act is by 2025, drug cost for all Medicare beneficiaries will be capped at $2,000, regardless of the plan or prescriptions you take. Currently, there is no max on some plans and people have been forced to make the decision to pay rent, get groceries or fill their medications. Our agency is thrilled for this ruling!
2023 Medicare Part D Costs
Just as in years past, your Part D coverage will consist of 4 coverage levels.
Phase 1: Deductible
- The 2023 standard deductible on Part D coverage is $505
- Not all plans have a deductible
- Most plans do not require the member to pay 100% for Tier 1 and Tier 2 generics
- Generally, on most plans, the deductible is only applicable on Tier 3, 4 and 5 medications
Phase 2: Initial Coverage
- After the deductible has been met, member pays co-pays
- Co-pays will vary by plan and pharmacy
- Plan also pays part of the drug (after the member pays the co-pay)
Phase 3: The Coverage Gap, aka “Donut Hole”
- Only 12% of Medicare beneficiaries fall into the Donut Hole
- If you and your plan spend $4,660 together, then you will fall into the donut hole
- Your drug cost will increase to 25% of the cost for generic and brand name drugs
- You will also pay a small pharmacy dispensing fee of about $1-$3 dollars
Phase 4: Catastrophic Phase
- About 5% of Medicare beneficiaries hit the catastrophic phase
- The threshold to hit the catastrophic phase is $7,400 (you and the insurance company)
- Member will pay 5% or small co-pays on medications for the remainder of the year
Common Medicare Part D Mistakes
We’ve been helping beneficiaries since 2014. S, we’ve seen and heard a lot from our clients and other Medicare members.
Below are the most common Part D mistakes we’ve encountered.
- I don’t take any drugs so I didn’t enroll in a drug plan. If you do not enroll in a drug plan and do not carry other creditable drug insurance, you could be penalized by Medicare. The Part D penalty is 1% per month for the lifetime of the policy. So, we always encourage our beneficiaries to at least enroll in the lowest premium Part D plan, even if they aren’t taking any medications. This way, they do not pay a penalty down the road.
- Using a non-preferred pharmacy. Using the right pharmacy is imperative when it comes to filling your prescriptions. Insurance companies have agreements with select “preferred” pharmacies that will provide a lower cost for your medication than other, non-preferred pharmacies.
- My plan works fine for me, my medications didn’t change, I don’t need to compare plans for next year. We do our best to place our clients on the best possible plan each year. And candidly, it would be great if we never had to change plans for them. But, Medicare drug plans can change every year. It could be premiums, deductibles, copays, covered medications, preferred pharmacies and more. At the least, check in with your agent to be sure there have been no significant changes to your plan.
Get Help Comparing 2023 Medicare Part D Plans (Medicare Drug Plans)
Our woman-owned, family-operated agency has assisted thousands of Medicare beneficiaries since 2014. Our licensed and knowledgeable agents will do the heavy lifting for you. We represent over 25 top-rated Medicare insurance companies and can efficiently help you find a plan to fit you.
Call 866-633-4427 now to speak with a licensed agent in your state. Or, Compare Medicare Drug plans now.
You can also click here to schedule an appointment at a time convenient for you.
Other Medicare Resources:
Medicare Extra Help with drug cost
Compare Medicare Advantage plans
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