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Part D Changes

Hello all, I hope your days are going well. I wanted to touch on the changes for Part D coverage for 2019. This has some good news and bad news, it’s the government so what would you expect! This news is actually what is fueling the recent mergers and acquisitions.

Here is an article for you to look over.

Part D coverage gap and manufacturer discount. This is going to speed up the Part D coverage gap, it was supposed to start in 2020 but they decided to start the process in 2019 instead.

Another good thing about the changes for 2019 is the insurance company must now share at least 1/3 of the manufacturer's discount price with you. In the past the discount went to the insurance company and that was it. Why this is important is when you are in the Donut hole. You were actually paying the percentage of the cost of the prescription at a retail price. The insurance company would apply the discount to their portion; therefore they were actually not paying their fair share. This is why you cannot use GoodRx or some other prescription discount card if you have Part D.

One other change is they are going to establish a true out of pocket maximum. They are doing this because they are phasing out the

So we have gone over some of the good things about the changes, let’s go over some of the bad. The required number of prescriptions in a therapeutic class will now only require one prescription per class instead of the current requirement of two. This is going to have an adverse effect on some Americans that are on a prescription if it is not in the therapeutic list. This is going to make it even more necessary to make sure your agent has the knowledge to go over your prescription list when you turn 65. That is CRUCIAL!

If you have any questions about Part D or anything Medicare related please give me a call and I will answer all of your questions in a manner that you will understand, so you can make the best decision for you.

All the best,


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