Medicare prescription drug plans can change every year, whether it’s the medications on your formulary or the way the plan is designed. While you may not always see a significant change in Medicare Advantage rates, here’s what to know about prescription drug costs in 2024.
Medicare Part D Prescription Drug Deductible
The Medicare Part D prescription drug deductible is $505 in 2023.1 Some plans can have much lower deductibles or even no deductible at all, but this number means no prescription drug coverage plan can have a deductible that exceeds $505.
Donut Hole
The Medicare Part D prescription coverage gap, also known as the “donut hole,” was slowly eliminated over the last 10 years, closing for brand-name drugs in 2019 and generic drugs in 2020. Although the donut hole has technically closed, it is still relevant to the way prescription Medicare costs are covered and how they count toward out-of-pocket totals and reaching the catastrophic coverage limit.
If applicable, after meeting the deductible, Medicare beneficiaries enter the Initial Coverage Stage and pay their copays or coinsurance until you reach the donut hole—for 2023, this means once you and your health plan have spent $4,660 on your medications.
Since the donut hole has closed, Medicare beneficiaries pay 25% of the cost of prescription drugs regardless of brand or generic while in the donut hole. However, it’s dependent on your Medicare Part D plan’s design, so if your plan is designed with a copay (instead of coinsurance), after the deductible and before the donut hole, your costs will change once you reach the donut hole.2
Changes in Standard Sharing Structure for Medicare Costs
As a result of annual changes to Medicare’s standard cost-sharing structure (how much enrollees pay out of pocket), there may be prescription drug plans with higher deductibles, higher initial coverage limits and higher out-of-pocket cost thresholds. At SelectQuote, we can help you ensure you’re getting the most out of the benefits available to you, including the right Medicare plan coverage for your prescriptions.
Insulin Costs With Medicare Prescription Drug Plans in 2023
As of January 1, 2023, your Medicare prescription drug plan can’t charge you more than $35 for a one-month supply of each insulin product covered by Part D, and you will not be subject to a deductible for your insulin. And, as of July 1, 2023, if you used an insulin pump covered under Medicare Part B, or if your insulin is covered by a Medicare Advantage Plan, your insulin costs will be capped at $35 per a one-month supply. Learn more about insulin costs at Medicare.gov.
Worried about your prescription drug costs? SelectQuote can help.
If you have seen an increase in prescription drug costs or have questions, our licensed insurance agents can help you determine what’s changed in your coverage and connect you to the appropriate resources.
1 https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/yearly-deductible-for-drug-plans#:~:text=This%20is%20the%20amount%20you,more%20than%20%24505%20in%202023 2 https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap
