Comparing Medicare Part D Plans for 2023

In 2023, 82% of Part D Stand-Alone Prescription Drug Plans are projected to operate from four popular insurers — United Health, Humana, Centene and CVS Health. Knowing average premiums from popular Part D companies can help you understand costs and which could be best for you.

What state you live in and drugs you need covered will affect the costs and which Part D plan will be best for you in 2023. When using Medicare’s plan finding tool, you should always input your prescription drugs and pharmacies to see the estimated costs.

For example, let’s say you take acebutolol, which is a common type of heart medication. If you need a 60-day supply of 200 mg acebutolol capsules, your costs vary depending on which Part D plan you choose. Below are different costs from the four most popular insurers of 2023. The costs are set for those looking for acebutolol coverage in Fort Bend, Texas.

There will be 801 total Medicare Part D stand-alone drug plans in 2023, which is a 5% increase from plans available in 2022.

Access to the Part D Low-Income Subsidy (LIS) program, also known as Extra Help, is slightly less accessible in 2023. There will be 191 Part D stand-alone drug plans that qualify for the LIS program in 2023, which is a 4% reduction compared to plans available in 2022. The LIS Program covers premiums and other out-of-pocket costs for Part D beneficiaries.

One of the biggest changes for Part D beneficiaries is the new cost cap for injectable insulin. Starting Jan. 1, 2023, injectable insulin will be capped at a $35 copay each month. The Part D deductible will also no longer apply for insulin products, according to the U.S. Centers of Medicare & Medicaid Services.

There will also be no cost-sharing for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) which are covered under Part D.

Be aware of a new benefit that was announced to cut costs in the future. Starting in 2025, your amount spent on prescriptions with Part D will be capped at $2,000 a year. According to AARP, this will be the first time there has ever been a cap on prescription drugs.

Finding the best price on a Medicare Part D plan requires you to compare the plans that are available where you live. You’ll have to consider four factors that will affect the cost of different Part D plans.

All these factors not only determine the cost of your monthly premium payments for a Part D plan, but they will also determine how much you’ll have to pay out-of-pocket for your medications.

If your costs are above the average monthly premium listed, you may want to continue shopping around to find a better deal.

Applying for Part D can be a lengthy and complicated process, but remain patient and continue comparing plans to ensure you’re getting the best cost for your unique coverage needs.

If you have concerns about covering Part D plan costs, you can always see if you’re eligible for the Part D Low-Income Subsidy program, which is also known as Extra Help.

The highest average monthly premium for a Part D plan in 2023 is $111 from AARP MedicareRx Preferred. The lowest average monthly premium for a Part D plan is $6 from SilverScript SmartSaver.

The number of companies offering stand-alone Part D plans has been declining in recent years as drug coverage has been increasing through Medicare Advantage plans. Only 15 national firms offer stand-alone plans in 2023, which is the lowest number since Part D started.

Similar to costs in 2022, you will continue to pay a much larger share of the costs of name brand and non-preferred drugs under national Medicare Part D drug plans in 2023. Non-preferred drugs can be both name-brand medications as well as generics.

Medicare Part D plans typically have five tiers of coverage, with your share of the cost lowest when you use the preferred drugs in the plan’s formulary. Preferred generics, generics and preferred brands typically have a dollar amount copay. Non-preferred and specialty drugs usually require you to pay a percentage of the drug’s cost as coinsurance.

All Medicare Part D plans are subject to the donut hole. But avoiding the donut hole — or Medicare Part D coverage gap — requires you to keep a watchful eye on how much you and your Medicare Part D plan are spending on prescription drugs.

You’ll also want to compare plans yearly before open enrollment — October 14 to December 7 each year — in case you need to move to a more cost-effective plan.

Once you and your plan spend a combined total of $4,430 on drugs in 2022, you enter what is known as the “donut hole.” It’s also called the Medicare Part D coverage gap.

Once you enter this donut hole, you are responsible for paying 25% of the costs for your medications.

You are responsible for this share of your medications until you hit the catastrophic coverage threshold — $7,050 out-of-pocket in 2022. Once you pay that much yourself, you only pay a 5% for the cost of your medications or $3.95 for generics and $9.85 for brand name drugs — whichever is greater.

Prior to Jan. 1 2020, when Congress closed the donut hole, you had to pay 100% of your medication’s cost.

A Medicare Part D drug plan should match your specific prescription drug needs. Taking the time to compare all the plans available in your area can save you hundreds of dollars.

Following the five tips below can help you choose a Medicare Part D plan that fits your needs.

You’ll need to know what drugs are covered, what pharmacies are in a plan’s network and a lot more information to make sure you’re getting the best plan for your needs.

When comparing plans, make sure you list all your medications. Leaving off just one medication can cost you hundreds of dollars.

You’ll need to include the dosage of each medication, how many you take and how often you take each. You’ll want to find a Part D plan that covers as many of your medications and leaves you with the least cost sharing.

Medicare Part D plans have preferred pharmacies. If you go to a pharmacy not on the plan’s list, you’ll have to pay more. If you have a favorite pharmacy, ask the pharmacist which plans have it on their preferred list.

You can also compare the plan’s price at your usual pharmacy to four other pharmacies in your area. Look for the lowest cost for both your premium and for your medications.

It can take a while to find the best Medicare Part D plan for you. There’s only a short window of time when you can join a plan or switch to a better one. So, it pays to do your work early.

Also, be aware of late enrollment penalties. If you don’t sign up for a prescription drug plan when you’re first eligible, you might have to pay a penalty when you finally do enroll. The penalty gets bigger each month you go without coverage and is added to your plan’s monthly cost when you finally do enroll in a Part D plan.

You may qualify for the Extra Help program if your annual income is limited to $20,385 for an individual or $27,465 for a married couple living together in 2022.

You can also contact your State Health Insurance Assistance Program (SHIP) toll free at 1-877-839-2675 or Medicare directly at 1-800-633-4227.

Editor Samantha Connell contributed to this article.