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2022 Medicare Part D plans in New York State

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Posted: 09 Oct, 2021
by Valerie Bogart (New York Legal Assistance Group)
Updated: 22 Jul, 2022
by Valerie Bogart (New York Legal Assistance Group)

The Annual Enrollment Period ("AEP" or "open enrollment") for Medicare Part D and Medicare Advantage plans for 2022 runs from October 15 through December 7, 2021.    

Every year, you should review your plan  options to see if your current plan still meets your needs - see more here what to  look for in the CMS Planfinder.   Click here for 2021 How to use Medicare Plan Finder, step-by-step - by CMS

2022 Part D Cost-Sharing Chart - Download from NCOA here.

2022 CMS Guide to Consumer Mailings - Notices sent about plan closings, reassignments, Extra Help

2022 Part D and Medicare Advantage plans announced here by CMS.  

  1.  Stand Alone Part D Prescription Drug Plans (PDP) -  (PDF) (Excel)  19 Plans (down from 28  in 2021)  in New York State for people in Original Medicare.  Chart shows the 2021 premium for comparison, and the 2022 premium for those with Full Extra Help.      FOUR  (down from 7 in 2021)  of the 19 plans are "benchmark" plans that have a ZERO premium for people with Extra Help subsidy. 

    • FOUR  BENCHMARK STAND-ALONE PDP PLANS with a FREE PREMIUM for people with FULL "EXTRA HELP" (Low Income Subsidy)   - chart shows changes from 2021

    •  Benchmark Premium is $42.43 in 2022.

    • People enrolled in Extra Help, either because they were approved for  Medicaid or  a Medicare Savings Program or because they applied to the SSA for Extra Help, are assigned to a benchmark plan if they don't pick one themselves and enroll.

    • Of the 3 plans that are no longer benchmark in 2022, members of two plans with Extra Help are being reassigned.  The 3rd plan, Elixir RxSecure, will no longer be "benchmark" because its premium is increasing.     Members of that plan with Extra Help will receive notices from CMS explaining their options.   See the chart for more about options for these members.See the chart for options for these members.

  2.  Medicare Advantage (MA) Plans (MA-PD) offered in NYS -  Also  see changes from 2021 in your county on q1Medicare.com (source for some info added to this chart)

  3. NYS Special Needs Plans. (SNP) - (Excel)  showing which plans are affiliated with a Medicaid Advantage Plus plan (also known as FIDE for Fully Integrated Dual Eligible)

All of the above lists have a column for "$35 Insulin - Senior Savings Model."  This is a program that began in 2021, in which both PDP and MA-PDP plans agree to cap copays for insulin at $35, includiing during the deductible period and donut hole.  This also shows up in Planfinder.  THis cost savings DOES NOT AFFECT  anyone with Extra Help since their costs are capped at the Extra Help copays. 

  • For people on EPIC and not Extra Help, this insulin program can save some money, especially while they are in their plan's deductible or the EPIC deductible.  Once they meet those deductibles, EPIC will pay all of the $35 except for a $7 copay.  

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.  Some extra information was added to the above charts by NYLAG, including some comparisons from 2021 plans, sourced from 2021 chart and  q1Medicare.com

Attached files
item Part D Benchmark Plans NYS 2021-2022 Comparison.pdf (231 kb) Download
item 2022 NYS Medicare Advantage Plan Landscape WITH Insulin.xlsx (159 kb) Download
item 2022 NYS Special Needs Plan Landscape with Insulin.xlsx (87 kb) Download
item NYS 2022 PDP Landscape (NYLAG) with insulin (10-18-21).pdf (122 kb) Download
item NYS 2022 PDP Landscape (NYLAG) with insulin (10-18-21).xls (157 kb) Download

Also read
item Pathways to Extra Help - the Part D low income subsidy and how it can help your clients
item Medicaid Advantage Plus "MAP" - New "FIDE" Appeals & Hearing Process began 2020 - Healthfirst Mistake March 2021
item Medicaid Recipients to be "Default Enrolled" into Medicare Special Needs Plans when they Enroll in Medicare-- April 1, 2021

Also listed in
folder Medicare Part D -> Overview

External links
http://www.wnylc.com/health/client/images/icons/article_out.svg https://www.health.ny.gov/health_care/epic/

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