Medicare Open Enrollment – Part D Drug Program Changes for 2019


Medicare Open Enrollment

Part D Drug Program Changes for 2019



The Medicare Open Enrollment period runs annually from October 15th through December 7thThis is the time Medicare beneficiaries can shop and change their Part D Prescription Drug Program and can switch from one Medicare Advantage Plan to another. In addition, those with Original Medicare with a Medigap (Supplement) Plan can switch to a Medicare Advantage Plan. All changes will become effective on January 1, 2019.


Each year, insurance companies can make changes to Medicare plans that will impact your out of pocket costs for premiums, deductibles and drug costs. In addition, if you have a Medicare Advantage plan, the insurance carrier can change the makeup of Physicians and Hospitals required to utilize.


Part D Drug Program (How to Shop)



It’s convenient to shop for your Part D, Prescription Drug Program. To do so, visit the website, You then click on “Sign Up, Change Plans” and then click find Health and Drug Plans. You will then enter your zip code, your medications and dosages followed by a preferred pharmacy. You will then see a spread sheet of all Medicare Prescription Drug Plans to choose. You will see both the premiums and out of pocket costs that are specifically associated with your prescription drugs. If you find a plan that is less costly, you will sign up directly through that company. Your new plan will be effective on January 1st 2019.



Drug Program Tiers



Until recently, we were used to our drugs being categorized into 1 of 3 tiers, “Generic, Brand or Specialty”. The Part D program has 5 Tiers, Preferred Generic, Non-Preferred Generic, Preferred Brand, Non-Preferred Brand and Specialty. Perhaps one of your prescription drugs this year is a Preferred Generic. If you don’t pay attention, your drug can be moved to Non-Preferred Generic, increasing your out of pocket costs. You are then stuck for a year with higher costs because you did NOT shop your plan. Please shop annually.



2019 Part D Drug Program Changes



This is based on the “Standard Medicare Benefit Design.” You will find plans that vary!


Initial Deductible:   Increases from $405 to $415. After you meet your deductible, you move to the Initial Coverage Period.


Initial Coverage Period: Increases from $3750 to $3820. Your obligation is to pay 25% of the costs of covered drugs while in the Initial Coverage Period:


When total drug costs exceed the combination of your deductible of $415 and the entire $3820 from the Initial Coverage Period, you enter the 2019 Donut Hole.


2019 Donut Hole: This is a significant reduction from 2018. You will pay 25% of the cost of Brand-Name drugs and 37% of the cost of Generic drugs.


When your total out of pocket costs exceed $5100 you enter the Catastrophic Coverage Portion where you drug plan will pay 95% of Covered Drugs for the remainder of the calendar year.



Approaching Medicare??



Do you have questions?


  • When to Enroll in Medicare? What is the difference between the Initial, Special and General Enrollment Periods?
  • Do you need to sign up for Medicare at age 65? What if you’re still working? What about your spouse?
  • What is the process of enrolling?
  • What is the difference between Original Medicare and a Medicare Advantage Plan? (Costs, Benefits, Networks)
  • How do Medicare Supplement Plans Work?
  • How does the Part D Prescription Drug Program Work?
  • What are the costs of the various parts of Medicare? 


If you have some of these questions and others, I encourage you to attend our Medicare Planning Workshop.

For information on upcoming dates and locations, PLEASE CLICK HERE MEDICARE WORKSHOP.




You Healthcare is Very Important



Please do not miss the opportunity of Medicare’s Open enrollment period to review your Medicare Coverage for 2019. After December 7th, you will not be able to change your coverage until next October with an effective date of January 2020!!



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