Medicare Part D

2022 Medicare Part D Changes

Starting January 1st, 2022:

  • The Part D monthly premium varies by plan.  
  • For stand-alone Part D prescription drug plans, average basic premiums increased to a projected average premium of $33.37/month.*
  • In 2022, brand-name drugs cost the enrollee just 25 percent of the plan’s cost.

*It is important to understand that the average basic premium is less than the average enhanced plan premium, so overall average Part D premiums are higher than the average basic premiums.

  • Most Medicare drug plans have a coverage gap (also called the “donut hole”).  This means there is a temporary limit on what the drug plan will cover for drugs.  Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount on covered drugs
  • In 2021, the coverage gap applied after an initial amount of $4,130 was spent. In 2022, the coverage gap applies after an initial amount of $4,430 is spent.  The good news is that the Affordable Care Act (ACA) has been gradually closing the coverage gap in Medicare Part D.  The percentage is set by Medicare. In 2022, once the coverage gap starts, Medicare members only have to pay 25% for both brand-name and generic prescriptions.

Medicare Part D is the newest addition to Medicare. Part D is the prescription drug plan. You must be enrolled in Medicare before you can apply for Part D coverage. Most people will pay a monthly premium for this coverage. Everyone with Medicare can get this coverage. It may help you lower prescription drug costs and help protect against higher costs in the future. Private companies provide the coverage. You choose the drug plan (there are many from which to choose) and pay a monthly premium. If you decide not to enroll in a drug plan when you are first eligible, you may have to pay a penalty if you join later.

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