Medicare Part D Cost Burden for 2018

medicare part d cost burden 2018; man carrying cardboard box with dollar sign over blue background

The Kaiser Family Foundation has released new statistics for Medicare Part D cost burden on enrollees in 2018. Founded in the 1990s, the Kaiser Family Foundation was established to study, document, analyze, and report on healthcare issues and their economic burden, especially for those living with low or limited income. Here are six statistics for Medicare Part D cost burden in 2018.

  1. Enrollment. Out of 60 million Medicare enrollees, over 43 million have prescription drug coverage under a Part D plan, and that number is only increasing. About 58% are covered by stand-alone prescription drug plans (PDP) while 42% are covered by Medicare Advantage prescription drug plans (MAPD).
  2. Plans. About 55% of enrollees are covered by three plans: UnitedHealth, Humana, and CVS Health. This includes both stand-alone PDP plans and MAPD plans.
    pie chart showing top 3 medicare part d plans
  3. Premiums. PDP enrollees have an average monthly premium of $41 in 2018, a 2% increase from 2017. Premiums vary based on which plan you have and where you live. For example, the premium for Humana Walmart Rx is $20 in 2018 while the premium for AARP Medicare Rx Preferred is $84. Plans that increased their premiums had lower enrollments in 2017, and plans that decreased their premiums had higher enrollments.
  4. Deductibles. Forty percent of Medicare Part D enrollees don’t pay a deductible with their plan. The other 60% of enrollees have plans with deductibles no greater than $405 in 2018.
  5. Drug costs. For most Medicare Part D plans, generic drugs cost between $1 and $37. However, brand-name and non-preferred drugs can carry a coinsurance rate of 40-50%, which can equal an out-of-pocket cost of $90-$100 and create a significant cost burden on enrollees who take medication not covered by their plan.
  6. Extra Help. Extra Help, or the Medicare Part D Low-Income Subsidy (LIS), exists to help low or limited income enrollees pay for their prescription drug coverage. The program shoulders some of the cost for premiums, copays, and coinsurance. But some program recipients are paying premiums even though they may qualify for premium-free coverage to reduce their Medicare Part D cost burden. In 2018, 1.2 million Extra Help recipients paid an average monthly premium of $26, which equals more than $300 per year. For more information about Extra Help and to see if you qualify, visit Social Security’s website.

For more information about the Medicare Part D cost burden, visit us at Medicare World for all Medicare Part D updates.

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