2017 Medicare Part D Prescription Drug Coverage

Part D prescription drug coverage

In 2017 there will be new changes to the Medicare Prescription Drug Coverage. Open enrollment is just around the corner. Open enrollment begins on October 15 and runs through December 7.

What are the changes coming in 2017 for Part D?

The Deductible

The initial deductible is increasing by $40, from $360 to $400. The deductible has increased by $80 since 2015 when it was $320.

Initial Cover Limit

The coverage limit will increase by $390 to $3,700  What this means is you won’t go into the donut hole until the retail value of your prescription drug purchases reaches $3,700. The coverage limit was $2,960 in 2015 and that has increased by $740.  In 2016 the coverage limit is $3,310.

This means you will be able to purchase a few more drugs in 2017.

The Donut Hole Co-payments

The 2017 generic drug discount is increasing from 42% to 49%. What does this mean? If your generic drug costs $100 you will have a co-payment of $51. This $51 will count toward your 2017 out-of-pocket spending limit. Medicare refers to this as TrOOP.

For brand-name drugs the discount is increasing to $60%. Ninety percent (90%) of the retail drug cost will count toward meeting the 2017 out-of-pocket maximum. And if your brand-name drug retail cost is $100, you will have a $40 co-payment, plus you will receive credit for $90 reaching your out-of-pocket costs.

Total Out-of-Pocket Costs

The total out-of-pocket costs will increase by $100 for a total of $4,950. In 2016 it is $4,850. Once you reach this limit you will now fall into Catastrophic Coverage.

In 2017 if you reach the Catastrophic Coverage phase you will pay the higher of 5% of the retail drug cost or:

$3.30 for generics
$8.25 for all other drugs

What this means if you have a drug that costs $200, you will not pay any more than $8.25 while in the catastrophic phase.

Although not great and COLA’s have been few and far between over the last several years, it does help many people with their prescription drug costs.

It is not too early to start reviewing your prescriptions. Remember to pay attention at the end of September when you should receive information from your plan about the costs and tier level changes.

If you are not sure, have questions, contact the State Health Insurance Assistance Program (SHIP) in your State, and schedule an appointment with a volunteer counselor to assist you with selecting the best plans for you in 2017.

Visit SHIP for more information



Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s