Medicare Part D provides coverage for prescription medications.
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 2019 Part D plan costs so that you can better understand your Medicare prescription drug coverage options.
The average premium for Medicare Part D plans in 2018 was $52.23 per month.
The average Part D plan deductible in 2018 was $244.98 per year.1
The table below shows the average premiums and deductibles for Medicare Part D plans in 2018 for each state.
from least expensive (1) to most expensive (46)
|District of Columbia||$40.98||T-1|
Learn more about Medicare Part D plans in your state.
Several factors can play into determining the cost of a Medicare Part D plan, such as:
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. In 2019, 29 percent of Part D plans have no deductible.2
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.
2019 Medicare Part D plans have a coverage gap, or “donut hole,” which represents a temporary limit on what the plan will cover for prescription drugs.
In 2019, you will enter the Part D donut hole once you and your plan have spent a combined $3,820 on covered drugs.
Once you reach the coverage gap, you will pay up to 25 percent of the cost of brand name drugs and up to 37 percent of the cost of covered generic drugs until you reach total out-of-pocket spending of $5,100 for the year.
Once you reach $5,100 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 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.
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:
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.
Compare Medicare plan costs in your areaCompare Plans
Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.
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1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, May 2018. Data retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.
2 Cubanksi, Juliette; Damico, Anthony; Neuman, Tricia. Medicare Part D: A First Look at Prescription Drug Plans in 2019. (Oct. 16, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/report-section/medicare-part-d-a-first-look-at-prescription-drug-plans-in-2019-tables.
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Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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