How much does Medicare Part D cost in 2024?

In 2023, 51.5 million Americans were enrolled in Medicare Part D drug insurance plans, according to the Center for Medicare Advocacy. The Congressional Budget Office estimated that $120 billion will be spent on the program in 2024. Medicare enrollees will contribute about 25.5% of that amount through Medicare Part D cost-sharing—monthly premiums, annual deductibles, copayments, coinsurance, and other out-of-pocket costs—but the remaining 75% is subsidized by the federal government.

Source: Medicare changes

Deductible

How much do you have to pay out of pocket before Medicare Part D coverage starts?

The cost of your Medicare Part D deductible varies depending on your drug plan. In 2024, the highest deductible price is $545, which is an increase from 2023 when it was $505. However, not all plans have a deductible.

Premiums

How much does Medicare Part D cost per month?

Since not everyone needs prescription drugs, Medicare prescription drug coverage is optional. 

For those with a Part D plan, you may have to pay a monthly premium. 

The Part D national base beneficiary premium—the amount Part D plans start at—can change from year to year, but in 2024, the national base beneficiary premium is $34.70 per month for each Part D beneficiary. 

There is also a Part D income-related monthly adjustment amount, or IRMAA, meaning that people with higher incomes may have to pay more according to their most recent tax return.

Source: cms.gov

Copays and coinsurance

How much does Medicare Part D cost per drug?

A copayment, or copay, is a set amount (for instance, $10) that you pay for a prescription each time you get it filled, while your Part D plan pays for the rest. 

Coinsurance means that you pay a percentage of the cost (for instance, 25%) of the drug each time you fill it while the plan pays the rest. 

Cost-sharing is set by each plan, and some plans have different copays or coinsurance for generic drugs and brand-name drugs. Each drug is assigned a tier on your plan’s drug formulary. The lower the tier, the cheaper the copay or coinsurance will be. Brand-name drugs are often included in more expensive, higher tiers.

Once you spend $8,000 on covered drugs, you’ll enter the catastrophic coverage stage. In 2024 and beyond, enrollees will no longer have to pay 5% of their drug costs during catastrophic coverage as they had in the past.

Recently, The Part D Senior Savings Model was introduced under The Centers for Medicare & Medicaid Services (CMS, previously referred to as the Social Security Administration). The program allowed participating Medicare prescription drug plans to offer a maximum copayment of $35 per month for insulin. This program was discontinued on Dec. 31, 2023, but the Inflation Reduction Act will keep monthly insulin costs at or below $35 for Part D beneficiaries.

RELATED: Does Medicare cover diabetic supplies?

Other Medicare Part D costs

Late enrollment penalties

A less obvious plan cost that some people get stuck with is the late enrollment penalty, which affects anyone who doesn’t opt for a Medicare Part D plan within their seven-month initial Open Enrollment Period but then decides to enroll in Part D later. The penalty, which is a percentage of the Part D national base beneficiary premium, goes up for each month you went without prescription drug coverage, and you will have to pay it for the life of your Part D drug plan—except for the following reasons: 

• You have “creditable” drug coverage, which is a plan that is at least as good as what Medicare offers. Most employer plans and ACA plans will qualify as creditable.
• You qualify for Extra Help.
• You have proof that you received bad information about whether your drug coverage before getting Part D was “creditable.”

Here’s an example of a late enrollment penalty:

Fred became eligible for Medicare in 2017, and his initial enrollment period ended on Jan. 1, 2018. Two years later, Fred hasn’t been on creditable drug coverage and decides to enroll in Medicare Part D, and his Part D coverage starts on Jan. 1, 2020. Fred will have to pay a late-enrollment penalty of 24% of the Part D national base beneficiary premium, which is one percentage point for each month. In 2024, that means Fred’s monthly premium would be $34.70 plus $8.30 (24% of $34.70). That number could go up or down each year based on the Part D national base beneficiary premium, but Fred will pay an additional 24% every month he has his drug plan in addition to any IRMAA he might be paying. However, if Fred can qualify for Extra Help, the penalty goes away forever.

Drugs that are not covered by Part D

Another factor that could contribute to prescription drug costs is if you need a medication that isn’t included in your plan’s drug list or formulary. Insurance companies compile a list of drugs related to your condition that they will cover. If you need a drug that isn’t on the list, you could end up paying full price for it. Also, if you are using a drug for off-label use, you could be responsible for the full cost of your drug—even if it’s on your formulary.

RELATED: What drugs are covered by Medicare Part D?

Is Medicare Part D ever free?

To help ease the burden on those who need help affording their prescriptions, Medicare Part D includes a low-income subsidy known as Extra Help. For individuals who qualify, Extra Help can reduce plan premiums, deductibles, and copays. It also will eliminate the late enrollment penalty and give people with Medicare a monthly Special Enrollment Period. Under the program, generic drugs should cost no more than $4.50, and brand-name drugs should cost no more than $11.20 in 2024, which will help keep you out of the Medicare Part D donut hole. To see if you qualify for Extra Help, visit ssa.gov. 

If you have Original Medicare (Parts A and B), you may be familiar with Medigaps, which are Medicare supplement insurance that helps lower the costs of Original Medicare. However, Medigaps do not include prescription drug benefits, so they will not help with the costs of Part D.

You can always use SingleCare to save on your prescriptions, even if you have Medicare. Your price with SingleCare may be more affordable than Medicare if you are in the coverage gap or if your medication isn’t covered by Medicare. For more info on how to use our savings with Medicare, read this article.

Lea este artículo en español aquí.