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2018 Medicare Part D and Medicare Advantage Plans - NYS

Views: 877
Posted: 10 Oct, 2017
by Valerie Bogart (New York Legal Assistance Group)
Updated: 17 Oct, 2017
by Valerie Bogart (New York Legal Assistance Group)

The annual coordinated election period ("open enrollment") for Medicare Part D and Medicare Advantage plans for 2018 runs from October 15 through December 7, 2017.  CMS has released the 2018 landscape of Part D and Medicare Advantage plans.  Here are the lists of plans for New York State:

  1.   Standalone Part D (PDP) - 20 Plans,  including 2 CIGNA  plans that were previously sanctioned are now available for enrollment and may market to potential members.  For those without Medicaid, Medicare Savings Program or "Extra Help," see below how premiums are changing in these plans. 

  2.   Medicare Advantage Plans - Click here for NYC plans, for link to all NYS counties click hereThese lists are extracted from the national lists on this CMS page.   For those without Medicaid, Medicare Savings Program or "Extra Help," see below how premiums are changing in these plans. 

  3.   Special Needs Plans (SNPs)

EIGHT BENCHMARK PLANS  HAVE A FREE PREMIUM FOR PEOPLE WITH FULL "EXTRA HELP" (Low Income Subsidy) All of the benchmark plans from 2017 will be benchmark in 2018:

  • EIGHT of the 20 stand-alone PDPs in NYS are free to people with FULL Extra Help in NYS in 2018 (no monthly premium). Benchmark plans are "Basic" Part D plans with premiums below the benchmark amount.  "Enhanced" Part D plans cannot be "benchmark" plans even if their premium is below the benchmark amount.

  • People with Extra Help, such as people newly approved for Medicaid or a Medicare Savings Program, will be assigned to one of these EIGHT Plans if they don't pick their own plan. They can pick a plan that is not one of the 8 benchmark plans, but they'll be charged the difference between the benchmark premium of $38.98 and the plan's full premium listed on the chart of stand-alone Prescription Drug Plans.

  • All plans that were benchmark in 2017 will still be benchmark in 2018:

  1. Aetna Medicare Rx Saver (PDP) 
  2. Cigna-Healthspring Rx Secure (PDP)
  3. Express Scripts Medicare - Value (PDP)
  4. Humana Preferred Rx Plan (PDP) 
  5. SilverScript Choice (PDP) (formerly called "Basic")
  6. WellCare Classic (PDP)
  7. EnvisionRxPlus Silver (PDP) 
  8. Magellan Rx Medicare Basic (PDP)

Every year, you need to review your plan and see if it still meets your needs - whether it covers your drugs, whether costs have increased, and, if you are in a Medicare Advantage plan, whether it still covers your preferred doctors and other providers, at the same costs.  See these tips from the Center for Medicare Advocacy to review your plan.

Helpful information about 2018 Medicare Part D -

NYS Plan Changes from 2017 -

People without Medicaid, MSP or Extra Help have choice of 20 PDP plans (last column of chart shows how much premium went up or went down since 2017)

  • 12 plans will have increased premiums in 2018 (Biggest increase is Cigna-HealthSpring Rx Secure-Extra from $43.60 to $62/month - $18.40/month increase)
  •  6 plans will have lower premiums in 2018, with reductions ranging from $2 to $3.70/month). 
  •  1 plan is closing (First Health Part D Premier Plus)
  •  2 new plans open (Express Scripts Medicare-Saver & Aetna Medicare Rx Select)

Medicare Advantage plans also have changes from 2017.  Looking at plans offered in Queens in NYC for example (look at second tab of NYC Medicare Advantage plan list to see changes):

  •  9 plans will  have increased premiums in 2018 and 6 will have lower premiums
  • 6 plans have higher deductibles in 2018 and 6 plans have lower deductibles. 
  • 4 plans are increasing their Maximum Out of Pocket (MOOP) costs and 2 are reducing the MOOP. 
  • The chart doesn't show how FORMULARIES are changing (which drugs the plan covers) or the coinsurance or copayments due on the drugs!!  
  • 3  plans have CLOSED since 2017 (the only Liberty Health plan closed, Aetna and Affinity each closed one plan) (Closed plans indicated in GRAY on 2nd tab of NYC List)
  • 3 new plans have opened in Queens County (Humana added 2 more plans)(New plans indicated in YELLOW on 2nd tab of NYC list)

Look to see if your plan’s premium and other costs are increasing, and if it still covers your drugs.  There may be a better plan for you. 

The lists posted here are extracted from nationwide charts on the CMS website at  http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/.    Sanctioned plans are also available at that link. 

EPIC REMINDER:

Reminder:  EPIC - NYS Drug insurance subsidy for people age 65+ -- does not provide coverage during the Part D deductible phase.   EPIC members without Extra Help will want to try to find Part D plans with no deductible, if possible.   In 2018, EPIC can pay the premium up to $38.98/month for people in the EPIC FEE plan,  and will credit EPIC deductible members $38.98/ month ($467.76/year) toward their annual EPIC deductible.    For more on EPIC see this article and go to EPIC's website.

This article authored by William Meyer & Valerie Bogart at NYLAG. 

Attached files
file 2018 NYS MAPD NYC with compare QUEENS 2017.xls (81 kb)
file 2018 NYS PDP Landscape compare with 2017.pdf (223 kb)
file Benchmark Plans 2017-2018 Comparison.pdf (150 kb)
file SNP MA 2018.xlsx (58 kb)
file NYS MA Landscape.xlsx (127 kb)

Also read
document Medicare Part D - Overview (2016)
document What you need to know about EPIC - New York's prescription drug program for seniors
document Medicare Savings Programs (MSP) in New York

Also listed in
folder Medicare Part D -> Selecting a drug plan

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