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What to Expect from Medicare Part D in 2019

Medicare Part D users can expect to see some improvements this year, as long-awaited changes (e.g., the removal of the coverage gap ) come into fruition. Here is what to expect in 2019:

Premiums Should Stay Under Control

The Centers for Medicare & Medicaid Services (CMS) report that the average monthly premium for a basic Medicare prescription drug plan in 2019 is projected to decrease by $1.09 (3.2 percent decrease) to an estimated $32.50 per month. The basic premium for an average Medicare prescription drug plan is projected to decline for a second year in a row.

Telling a slightly different story, The Kaiser Family Foundation reports that the average monthly prescription drug plan premium will increase by a modest 2 percent between 2018 and 2019, to $41.21, weighted by September 2018 enrollment. These premiums will vary widely across plans, as in previous years.

Among the 10 prescription drug plans with the most enrollees, average premiums will range from a low of $28 per month ($332 per year) for Humana Walmart to a high of $76 per month ($911 per year) for Humana Enhanced.

Low-Income Beneficiaries

Medicare beneficiaries receiving the Low-Income Subsidy (LIS) will have a choice of six premium-free prescription drug plans in 2019, on average, the same as in 2018. In 2019, nearly one million low-income beneficiaries who are eligible for premium-free Part D coverage will pay Part D premiums averaging nearly $28 per month ($333 per year), unless they switch or are reassigned to premium-free plans.

The Donut Hole Should Shrink – Even Disappear

Most Medicare drug plans have a coverage gap, which begins in a given year after you and your drug plan have spent a certain amount of money on prescription drugs. This gap is often referred to as the “donut hole.”

In 2018, once you and your plan spent $3,750 on covered drugs, you were in the donut hole.

While in the coverage gap, your Medicare plan only covered a percentage of your costs, and you were required to pay the rest out-of-pocket until you automatically qualified for catastrophic coverage .

Under the Affordable Care Act (ACA), the donut hole was scheduled to close in 2020 . But the spending bill Congress passed in March of last year will close the donut hole for brand-name drugs in 2019. The gap will close for generic drugs in 2020.

Paying for Your Prescription Drugs in 2019

Regardless of what your premiums are or how close you are to falling “in the gap,” there are many ways to ensure you can afford your Rx medications on Medicare Part D .

Be sure to always ask your doctor and pharmacist about the best ways to pay for your prescriptions , research coupon options, and consider using a free pharmacy discount card like FamilyWize . FamilyWize cardholders save an average of 45 percent on their prescription medications.

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