Medicare Part D open enrollment and what recent changes mean for beneficiaries

It’s that time of year again: Medicare open enrollment! Seniors and people with disabilities who are newly eligible for Medicare, as well as current Medicare beneficiaries, can select or update their Part D prescription drug plans for 2023 through Wednesday, December 7. Part D beneficiaries have a variety of plans to choose from, ranging from 24 to 32 options in each state. As a result of Part D, nearly 90% of Medicare beneficiaries have comprehensive drug coverage, amounting to more than 47 million beneficiaries in 2020. But open enrollment can be confusing.

Luckily there are many resources available to help seniors and people with disabilities make the choice that’s best for them.

• Resources include online tools through medicare.gov that help patients or caregivers understand the basics of Medicare, compare plans and more. Open enrollment resources are also available in languages other than English.
• Medicare’s plan finder can be particularly helpful for finding the right plan with coverage of the medicines individual beneficiaries may need.
• Patients or caregivers can also call the 1-800-MEDICARE (1-800-633-4227) helpline to speak with someone directly about options.
• Doctors can also help narrow down which plan works best by determining which medicines need to be covered. Consider whether a plan will cover all needed medicines, which pharmacies are preferred or in-network, or if the plan offers mail-order pharmacy refills, if that’s important to the patient or caregiver.

In case you missed it, the recently passed Inflation Reduction Act included some changes that will help patients at the pharmacy starting in 2023 — like requiring plans to limit copays for covered insulins to $35 and offering zero cost sharing for certain Part D vaccines.

But, unfortunately, policymakers didn’t do nearly enough to stop insurer and pharmacy benefit manager abuses. Data recently released from MedPAC show that while insurers and PBMs who sponsor Part D plans are saving money, Part D beneficiaries are paying more. To make changes that meaningfully lower patient out-of-pocket costs, policymakers should ensure that seniors’ cost sharing is based off the net price Part D plans pay, not the list price.

Learn more about Medicare Part D and enroll in a plan here.