How Much Does Medicare Part D Cost In 2019?
Part D drug coverage provided by Medicare is fairly inexpensive for most beneficiaries. As with any Medicare plan, the coverage is subsidized, which means the taxpayers pay the largest share of the costs. Below are some general guidelines regarding how much each individual will pay for Part D drug coverage in 2019.
Most Medicare beneficiaries who have not yet reached their initial enrollment period will pay $35.00 per month.
Those who are still on the Initial Enrollment Period will pay $33.00 per month until their Initial Enrollment Period has ended.
Individuals who have reached the “donut hole” will pay $28.50 per month.
A new provision in the Affordable Care Act will be in effect in 2019. This provision is called the “Saver's Credit” and will provide a tax credit of a portion of the cost of your Part D plan. This credit is variable on your income and will range from 50% to 35% of your costs.
(This information is current as of 2019. Source: Medicare.gov).
Medicare Part D Cost Comparison
To make a great point, let's compare the cost of Medicare Prescription Drug Coverage to other popular plans.
Medicare Part D vs. Part C
Part D is a form of drug coverage offered by Medicare that does not cover “inpatient” or “outpatient” services. Medicare Advantage plans, or “Part C”, covers both types of services.
If you have the option to select Part D or Part C in 2019, your Part D costs should be roughly $59.65 per month. Part D will be about $200 less than a Part C plan.
Medicare Part D vs. PPO Plan (Private Insurance)
In 2019, the average monthly premium for a PPO plan will be about $186.00. The average co-pay for a prescription is about $41.00. For a Medicare Part D Plan, the average monthly premium is about $35.00 and the average co-pay for a prescription is about $10.00.
How Medicare Part D Works
The way Part D works is simple. You pay $35.00 each month to receive your prescription drug coverage. You pay this $35.00 each month whether or not you take any prescriptions. If you choose a plan that has a co-pay, you will not receive coverage until you have paid the co-pay.
At that point, your pharmacy will fill your prescription. Once it is filled, you will receive your first Part D benefit, whether it is a co-pay or a free supply.
At this point, you will have also met your deductible. Depending on the plan you choose, you can have a deductible in the thousands of dollars or in the hundreds of dollars. Once your deductible is met, you will receive coverage for 80% of your prescriptions.
The co-insurance is slightly different. You will only pay 20% of your co-insurance cost after your deductible is met. If you choose a plan with a co-pay, you will pay your co-pay and will also pay 20% of your co-insurance. This coverage will last until you reach the “donut hole”.
The “donut hole” is the point at which you will pay more for your prescriptions. While still receiving 80% of your prescription costs, you will not pay anything for your co-insurance. Once you reach the end of the “donut hole”, you will again receive a full year of coverage on your prescriptions. You will continue to receive this coverage until you reach the “catastrophic” level.
The “catastrophic” level is the point at which your prescription costs will be at 100% of your costs. Once you reach this point, you will not have to pay anything for your prescriptions.
If you wish to continue the coverage after your initial enrollment period ends, you will have to re-enroll in the program. Depending on your situation, you may be able to re-enroll on a month to month basis or will have to wait for a predetermined time until you can re-enroll. You should discuss this with your personal Medicare representative.
Deductibles and Co-Pays
If you have a deductible, you will be responsible for paying these costs before you are eligible for coverage. If you have a co-pay, you will pay this amount each time your prescriptions are filled.
Co-insurance is the amount you have to pay after you have met your deductible. Until you reach the “donut hole”, you will pay 20% of your co-insurance.
Part D plans offered by Medicare have a “deductible”. This means that you are responsible for the cost of your prescriptions until you meet that deductible amount. Once you reach the deductible, you will begin to receive coverage for 80% of your prescription costs.
Part D plans also have a “co-pay”. This means that you are responsible for a certain amount of your prescriptions a month. This amount is determined by your plan and will vary from plan to plan.
The co-insurance is the percentage of your prescription costs that you will pay after you have reached your deductible. As long as your prescriptions are in the coverage gap, you will not pay anything for your prescription costs. Once you have reached the “donut hole” you will pay 20% of your co-insurance.
The “donut hole” is the coverage gap that you will enter when your