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Medicare Part D Costs

Medicare Part D Premiums for 2014

Premiums for Medicare Part D insurance not only vary by plan but may also vary by carrier and location. Additionally, a Part D plan may change is premium each year based on inflation and estimated cost increases. Given this situation, the most affordable Part D plan for you last year may not be the right plan for you this year. For example, beneficiaries enrolled in one of the top ten prescription drug plans may see an increase of six percent in their plan premiums from 2012 to 2013. The six million beneficiaries enrolled in seven of these top plans could see increases ranging from 11 to 23 percent. Overall, average prescription drug plan premiums in 2014 may range from $12.50 to $174.70, while some plans may also have a $0 premium. By reviewing your Part D plan options annually, you are in the best position to maximize your savings and available benefits.

The government has a program to assist low-income Part D enrollees with their Part D deductibles, premiums, and copayment expenses. The program is known as Extra Help or the "Low Income Subsidy" (LIS). For more information about the Extra Help program, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.

Deductibles and Other Costs

A standard Medicare-contracted Part D drug plan includes a certain period of time in which you are responsible for covering 100% of your drug costs until the deductible amount is satisfied. The standard deductible amount decreased from $325 in 2013 to $310 in 2014. This is considered the maximum amount that you will have to cover out-of-pocket before the plan begins coverage. After you spend an amount equal to the deductible, you will pay a copayment (or a coinsurance fee representing a percentage of the drug's full price) for a covered drug. Some Part D drug plans waive the deductible or reduce it to a lower amount.

The most affordable Medicare Part D plan for you may not necessarily be the Part D plan with the lowest monthly premium. A Part D plan may also involve deductibles, out-of-pocket expenses for drugs, and the coverage gap, or "Part D donut hole." In 2014, the coverage gap begins at the standard initial coverage limit of $2,850, an increase from the $2,970 in 2013. After a beneficiary reaches this amount, he is responsible for all prescription drug costs up to the out-of-pocket limit, which is $4,550 in 2014. Part D enrollees are given a 52.5% discount on the cost of brand-name drugs in the donut hole, and will pay a maximum of 72% of the copayment for their generic drugs.

PlanPrescriber highly recommends that you use our Part D plan comparison tool or similar tool to objectively compare your annual Part D drug coverage costs (i.e. premiums, deductibles, and out-of-pocket expenses) among Part D plans for the drugs you are currently taking. By evaluating all your medication-related spending, you can make a more informed choice on what Part D plan may be right for you.



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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.

 
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