Medicare Part D Premiums To Drop For Second Straight Year

By: Edward Neeman
Published: Thursday, September 06 2018
Last Updated: 4 years ago

It may seem like all you ever read regarding your healthcare costs and insurance premiums bad news. Well, if you are a Medicare Part D recipient, there are actually some promising developments on that front. The Centers for Medicare & Medicaid Services (CMS) report that your Medicare Part D premium is likely to drop in 2019. This is the second year of great news for Part D members, coming on the heels of a premium decrease for this year's rates.

If you aren’t yet Medicare age, Medicare Part D is a prescription drug plan that Medicare recipients can buy to cover their pharmacy and prescription needs. You can choose a prescription drug plan that fits your needs and budget.

It is a voluntary program, and the Part D premium is separate from your regular Medicare premiums. Like all things in healthcare, the cost for the Medicare prescription drug plan had been on the rise, until recently.

Changes Coming To Your Medicare Part D Premium In 2019

CMS has said your Part D costs will decline by about 3% for 2019. That means an average Medicare Part D premium will now be $32.50 a month, down from $33.59 in 2018. The average bid the Part D providers submit, valued against their enrollment numbers, has also declined from $57.93 to $51.28.

Why Are Costs Still Declining?

The decline in the Part D cost is great news, but you can be forgiven if you are confused, given all the doom and gloom that usually surrounds healthcare costs. CMS has credited pressure from the Federal Government on drug makers as one reason for the lower costs. CMS has granted more bargaining power to the Part D providers. This has forced drug manufacturers into a more competitive environment in the hopes of increasing their Part D business.

CMS has taken the additional step to approve more generic drugs for your Medicare Part D coverage. This also includes lowering costs for low-income seniors to buy what are known as biosimilar drugs. These are medications that the FDA (Food & Drug Administration) deems biologically identical to drugs they have already approved.

The decline in your Part D cost may also be because of changes CMS has made in Part D’s relationship to your local pharmacy. In the prior years, the pharmacy network for Part D members was more limited. Part D recipients now have a larger list of accepted pharmacies to choose from. This, combined with an increasing number of plans available, competing for your business, have helped put downward pressure on your Medicare Part D premium.

Is There A Catch?

If you are thinking there must be more to this, you aren’t completely wrong. Separate from the steps CMS has taken to create a more competitive environment, there are changes to the plans themselves you should know. Your Part D plan may now offer less comprehensive coverage than it did in the past. This means some plans may cover fewer prescription drugs, or come with higher copays and deductibles.

You should confirm your current Part D plan will continue to meet your prescription needs, or you may need to switch another Part D plan. These changes don’t affect all plans, but they are a contributing factor to the overall decline in premiums.

What Other Changes Are Coming To Medicare Part D?

In another piece of good news for your Part D cost, CMS has added an additional income bracket to the Medicare Part D premium surcharges. These are additional premium costs high-income earners are charged; basically, any individual who makes more than $85,000 or joint tax filers making more than $170,000, per year.

Starting in 2019, there is an additional bracket at the top for earners making more than $500,000 as single filers, or $750,000 as joint filers. These top earners will pay more while the surcharges for the 4 brackets beneath that will now pay less. This means if you've struggled to find the money for your premiums in years past, you will most likely be getting some good news.