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2019 Medicare Part D Plans in NYS - Stand-Alone and Medicare Advantage

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Posted: 28 Sep, 2018
by Valerie Bogart (New York Legal Assistance Group)
Updated: 05 Oct, 2018
by Valerie Bogart (New York Legal Assistance Group)

The annual coordinated election period ("open enrollment") for Medicare Part D and Medicare Advantage plans for 2019 runs from October 15 through December 7, 2018.    Every year, you should 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. 

CMS has released the nationwide 2019 landscape of Part D and Medicare Advantage plans.  Here are the lists of plans for New York State:

  1.   Standalone Part D (PDP) - 23 Plans for people in Original Medicare..  Eight of these are "benchmark" plans that are free for people with Medicaid, the Medicare Savings Program, or others with Extra Help.  See more here.   

  2.   Medicare Advantage Plans offered in NYS (Excel) 

  1.   Special Needs Plans (SNPs)  in NYS  (Excel)   - national list available here .  Also see detailed list. 

 

EIGHT BENCHMARK  Stand-alone PLANS  HAVE A FREE PREMIUM FOR PEOPLE WITH FULL "EXTRA HELP" (Low Income SubsidyAll of the benchmark plans from 2018 will be benchmark in 2019:

  • EIGHT of the 20 stand-alone PDPs in NYS are "benchmark" plans that are free to people with FULL Extra Help in NYS  (no monthly premium). Benchmark plans are "Basic" Part D plans with premiums below the benchmark amount, which is  $39.33 in 2019.   "Enhanced" Part D plans cannot be "benchmark" plans even if their premium is below the benchmark amount.  In an enhanced plan, the premium is subsidized for people with Extra Help but not always fully.   See this article.

  • 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 $39.33 and the plan's full premium listed on the chart of stand-alone Prescription Drug Plans.

  • All plans that were benchmark in 2018 will still be benchmark in 2019:

  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)

Helpful information about 2019 Medicare Part D -

NYS Plan Changes from 2018 -

People without Medicaid, MSP or Extra Help have choice of 23 PDP plans (last  2 columns of chart shows how much premium and deductible went up or went down since 2018, other than deductibles that  remained at the maximum ( $405 in 2018 to $415 in 2019)

  • 10 plans will have increased premiums in 2019 (Biggest increase is  Humana Walmart Rx Plan (PDP)  increased from $20.40 to  $35.70/month   ($15.30 increase)
  •   9 plans will have the same or lower premiums in 2019, with reductions ranging from 20 cents to $13.40/month). 
  •  1 plan is changing its name from First Health Part D Value Plus (PDP) to Aetna Medicare Rx Select Value Plus (PDP)    
  •  3 new plans open -- all "Enhanced" plans   -- Cigna-HealthSpring Rx Secure-Essential (PDP), SilverScript Allure (PDP), and WellCare Value Script (PDP)

Medicare Advantage plans - See Queens list.showing changes since 2018.    See Statewide 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 $39.33/ month ($443.88/year) toward their annual EPIC deductible.    For more on EPIC see this article and go to EPIC's website.

Attached files
item 2019 NYS MA Queens 2019-2018 comparison.2.pdf (203 kb) Download
item Benchmark Plans 2018-2019 Comparison.pdf (149 kb) Download
item 2019 NYS PDP 2019-2018 comparison.2.pdf (62 kb) Download

Also read
item Medicare Part D - Overview (2019)
item Pathways to Extra Help - the Part D low income subsidy and how it can help your clients
item CMS reminds Part D plans of transition fill policy for current enrollees

Also listed in
folder Medicare Part D

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Selecting a drug plan       2018 Medicare Part D and Medicare Advantage Plans - NYS


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