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It’s that time of year again, where PDP enrollment goes wild and we all kick it into high gear. We’ve taken a look at the 2023 Part D carriers, and there are several that look really good.
Here's a quick look at Part D changes for 2023, the most competitive Part D carriers for 2023 across the board, and a reminder to get set up with MedicareCENTER.
Part D Changes for 2023 and Beyond
The maximum Part D deductible for 2023 is $505, up from $480 in 2022.
Some of the biggest changes coming to Part D are a result of the Inflation Reduction Act (IRA), which was signed into law in August 2022. Part of this act targets prescription costs and other pricing issues facing Medicare beneficiaries.
Here's a quick summary of some of the most impactful changes coming to Medicare Part D:
- The shingles vaccine is free starting January 1, 2023 (lots of other vaccines will also be free but this one was the most notable)
- Copay for 30-day supply of Part D-covered insulin will be capped at $35 (January 2023 through the end of 2025)
- Starting January 1, 2024, Part D members that enter the catastrophic phase will have no additional out-of-pocket costs for the rest of the year
- Starting January 1, 2024, Part D plans can’t increase their premium more than 6% per year
- $2,000 out of pocket maximum starts January 1, 2025
- "Smoothed" cost sharing starts January 1, 2025 (spreading out cost-sharing payments over the course of the year)
- Price negotiations on expensive drugs with no alternatives begins in 2026
You can read more about the Inflation Reduction Act here.
Most Competitive 2023 Part D Carriers
As always, everything is based on your location, but when we run comparisons in a variety of areas, we definitely see some trends.
The most competitive carriers for 2023 are sure to be SilverScript, Wellcare, and Cigna.
For 2023, the SilverScript SmartRx PDP will become called SilverScript SmartSaver. Beneficiaries you previously enrolled in SilverScript SmartRx will remained enrolled in the SmartSaver plan for 2023.
The SmartSaver plan is going to be the lowest premium plan at just $4.90 per month in our area. The national average monthly premium is just $5.92!
A few notes:
- $10 copays for select insulins at preferred pharmacies
- Improved formulary coverage from 2022
- The SilverScript SmartSaver plan will not be commissionable for new sales. (Clients you previously enrolled in SilverScript SmartRX will remain enrolled in the SilverScript SmartSaver in 2023, and you will continue to receive renewal commissions for these members.)
For clients who only take a few medications, this could be a great money-saving plan. It's also great for clients who don't take any medications but want to avoid the Part D late enrollment penalty.
As with any drug plan, be sure you coach up your client on the pharmacy of choice.
Preferred generics have a $2 copay and generics have a $15 copay, so just be mindful of the total annual cost. Other plans with slightly higher premiums but lower copays may be cheaper in the long run.
In 2023, Wellcare will offer a total of 102 Prescription Drug Plans nationwide.
- Three plans will be offered in all 34 regions across all 50 U.S. states and the District of Columbia.
- All plans will feature a $0 Tier 1 benefit when filled at preferred pharmacies, including Amazon, Walgreens, CVS, and most grocers
- Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on Value Script and Value Plus products
- A new formulary design will be offered on the Value Script and Value Plus plans; it will contain medications commonly used to treat diabetes and will cost only $11 per 30-day supply
- Plans offer competitive formularies that are 89% aligned or favorable in coverage and tier placement for the top 400 drugs (96% of Medicare utilization) compared to plans nationwide
The Wellcare plans for 2023 are the same as last year but with slight premium changes.
|2022 Premium||2023 Premium|
|Wellcare Value Script||$11.70 in our area||$8.30 in our area|
|Wellcare Classic||$26.20 in our area||$29 in our area|
|Wellcare Medicare Rx Value Plus||$68.30 in our area||$71.30 in our area|
*Our area is zip code 62526, central IL
For clients who take several preferred generics, the Wellcare Value Script is likely going to be the most competitive plan for them.
This year, Cigna also is offering the following three standalone Prescription Drug Plans (PDPs) in all 50 states, the District of Columbia and Puerto Rico:
- Cigna Saver Rx: This new, economical plan includes low premiums, low copays and savings on generic drugs ($12.10 premium in our area)
- Cigna Secure Rx: Available to serve customers with a low-income subsidy ($26.40 premium in our area)
- Cigna Extra Rx: Provides a high level of coverage and savings on select insulins with copays as low as $0 at a preferred pharmacy ($65.40 premium in our area)
All plans have $0 copay options for select medications purchased through preferred home delivery. Also, Cigna's preferred pharmacies include Walgreens, Walmart, Winn Dixie, Sams Club, and Rite Aid.
As always, the best plan for your client will depend on their prescription and pharmacy of choice.
If you haven't registered for MedicareCENTER yet, do that now!
You can quote and enroll your clients right in MedicareCENTER.
There are also some big updates for this AEP:
- Call Recording, an incredibly powerful yet easy-to-use solution to the latest CMS requirements. Learn more here.
- New Mobile App, which provides easy access to everything you need in MedicareCENTER. Manage your book of business, stay compliant, quote and enroll with ease. Download on the App Store or Google Play! Learn more here.
- LeadCENTER Integration, which provides fast access to quality leads. With this amazing integration, you can set up campaigns in a few quick steps to have fresh leads delivered right to their MedicareCENTER CRM from LeadCENTER — all at the flip of a switch! We’re bringing two powerful platforms together to make building a book of business more efficient than ever. Learn more here.
- Activity Management, which allows you to track the full history of interactions with each client at a glance, including sales calls, status changes, notes and more.
- CRM Tagging, which allows you to create dynamic tags that can be assigned to contacts in MedicareCENTER's CRM. Tags can be searched and sorted, helping you easily find clients based on lead source, plan type, recommendations or any other important attributes to the client.
Learn more about MedicareCENTER here.
For 2023, SilverScript, Wellcare, and Cigna are going to be excellent Part D choices for many of your clients.
Make sure you get contracted and register for a MedicareCENTER account if you haven't already.
New to Part D sales? Check out our comprehensive sales guide, How to Sell Medicare Part D.