Updates for 2018 Medicare Part D
By Tucker Thompson, CSA
Medicare Part D Pharmacy benefits will change January 1, 2018. The cost of the plan you chose will not be prorated no matter when you start the plan. The Prescription Drug Plan deductible will range from $0 to $405 depending on the plan you choose. After you meet your plan’s deductible, you will have co-pays that vary depending on the drug cost in your plan. The initial coverage limit will increase to $3,750. This is the cost of the drug paid for by you and your plan. To be covered, the prescription drug must be in your plan’s formulary, unless an exception is granted by that company.
After you reach the prescription coverage gap, or “donut hole”, your co-pays will change. The cost of brand name drugs will then be 35% and generic drugs will be 44% of your plan’s cost. For example, a brand name drug may cost $100 but you would only pay $35.
If you reach $5,000 in prescription drug costs in your plan, you will begin catastrophic coverage through December 31, 2018. You will now pay $8.35 or 5%, whichever is higher, for brand name drugs in your plan’s formulary. Generic drugs will cost $3.35 or 5% in your plan’s formulary.
The key to your Prescription Drug Plan is the plans formulary, with the list of drugs that you take. The monthly fee and pharmacies in your plan’s network should also be a factor when picking a Prescription Drug Plan.
If you filed joint income tax in 2016 and made more than $170,000, or filed single with more than $85,000 in adjusted gross income, you will pay an additional monthly fee for a Prescription Drug Plan depending on your income for 2016. The government always looks two years back at your adjustable income tax. In 2017, the government looked at your 2015 income tax filed to determine if you had to pay an additional fee.
The annual enrollment period for Prescription Drug Plans is from October 15 through December 7, 2017 with coverage starting January 1, 2018. There are no health questions.
Tucker Thompson, CSA, has worked in the insurance field for over 24 years in Life Insurance, Long-Term Care, Medicare Supplements, Medicare Advantage Plans, and Prescription Drug Plans.