What Is the Average Cost of Medicare Part D Plans in Each State?

• by Christian Worstell
• November 18, 2021
• Reviewed by John Krahnert

Medicare Part D provides coverage for prescription medications. The average Part D plan premium in 2022 is $47.59 per month.¹

Because Original Medicare (Part A and Part B) does not cover retail prescription drugs in most cases, millions of Medicare beneficiaries turn to Medicare Part D or Medicare Advantage prescription drug (MA-PD) plans to get help paying for their drugs.

In this guide, we list the average costs of Medicare Part D plans by state so that you can see how your state averages compare.

We also detail Part D plan costs so that you can better understand your Medicare prescription drug coverage options.

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.²

How much does Medicare Part D cost?

As mentioned above, the average premium for Medicare Part D plans in 2022 is $47.59 per month.

The average Part D plan deductible in 2022 is $367.80 per year.¹

The table below shows the average premiums and deductibles for Medicare Part D plans in 2022 for each state.

What affects Medicare Part D costs each year?

Several factors can play into determining the cost of a Medicare Part D plan, such as:

• Drug formulary
  Each Medicare Part D plan contains a formulary, which is a list of drugs covered by the plan.
  
  Covered drugs are divided up into different tiers. Generic drugs are typically on lower tiers and cost less, while brand name drugs and specialty drugs are typically on higher tiers and cost more.
  
  
• Local competition
  Medicare Part D plans are sold by private insurance companies. These insurance companies are generally free to set their own premiums for the plans they sell.
  
  Medicare Part D plan costs in any particular area may depend partly on the cost of other plans being sold in the same area by competing carriers.
  
  
• Cost-sharing
  Some Medicare Part D plans have deductibles and copayments or coinsurance.
  
  The cost of your Part D premium may depend on the amounts of coinsurance or copayments you pay with your plan, as well as whether or not your plan has a deductible.

Your Part D deductible is the amount that you must spend out of your own pocket for covered drugs in a calendar year before the plan kicks in and begins providing coverage.

Copayments and coinsurance are the amounts that you must pay once your plan’s coverage does begin.

A copayment is usually a fixed dollar amount (such as $5) while coinsurance is most often a percentage of the cost (such as 20 percent). Plans might have different copayment or coinsurance amounts for each tier of drugs.

The Medicare Part D “donut hole” coverage gap

After 2020, Medicare Part D plans have a shrunken coverage gap, or “donut hole,” which represents a temporary limit on what the plan will cover for prescription drugs.

You enter the Part D donut hole once you and your plan have spent a combined $4,430 on covered drugs in 2022.

Once you reach the coverage gap, you will pay up to 25 percent of the cost of covered brand name and generic drugs until you reach total out-of-pocket spending of $7,050 for the year in 2022.

Once you reach $7,050 in out-of-pocket spending, you are out of the donut hole and enter “catastrophic coverage,” where you typically only pay a small copayment or coinsurance payment for the rest of the year.

Extra Help for Medicare Part D

Extra Help is an assistance program that helps lower income individuals more easily afford Medicare Part D. Extra Help helps pay for Part D premiums, deductibles and copayments/coinsurance.

Learn more about Medicare Part D Extra Help, including how to qualify, where Extra Help is offered and how to find other assistance programs designed to help cover Part D prescription drug costs.

Most Medicare Advantage plans offer prescription drug coverage

Medicare Advantage plans are an alternative to Original Medicare (Part A and Part B).

Medicare Advantage plans (also called Medicare Part C) provide all of the same coverage as Medicare Part A and Part B, and many plans include some additional benefits that Original Medicare doesn’t cover.

Some of these additional benefits can include things like:

• Prescription drug coverage
• Routine dental, vision and hearing care
• Membership to health and wellness programs like SilverSneakers

Read additional medicare costs guides to learn more about Medicare costs and how they will affect you.

Learn more about your Medicare Advantage prescription drug coverage options

The cost of a Medicare Part D plan may vary from one insurance company to the next and from one location to another.

One way to learn about your Medicare prescription drug coverage options is to speak with a licensed insurance agent. You can compare Medicare Advantage plan costs in your area and find a plan that covers the prescription drugs you need.

¹ MedicareAdvantage.com's The Best States for Medicare report.

² 10-minute claim is based solely on the time to complete the e-application if you have your Medicare card and other pertinent information available when you apply. The time to shop for plans, compare rates, and estimate drug costs is not factored into the claim. Application time could be longer. Actual time to enroll will depend on the consumer and their plan comparison needs.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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