Changes to Medicare Part D for 2016

2016 Part D Changes:

IMPROVEMENTS:

  • The Standard Part D Deductible is increasing from $320.00 to $360.00.
    • The Deductible amount that you spend is not counted towards your total that is used for calculating when you enter the Coverage Gap aka the “Donut Hole”. This higher deductible may help you avoid or delay the Donut Hole in 2016.
  • The out-of-pocket amount that you and your Part D Plan spend in the “Initial Coverage Level” is increasing.
    • In 2015, once you and your Part D Plan have spent $2,960.00 you enter the Donut Hole. This amount is also increasing in 2016 to $3,310.00. This means that the Donut Hole will be delayed by $350.00 in 2016.

 

THE NOT-SO-GOOD CURRENT RULES AND CHANGES TO PART D:

  • Prior authorization: You and/or your prescriber must contact the drug plan before you can fill certain prescriptions. Your prescriber may need to show that the drug is medically necessaryfor the plan to cover it.
  • Quantity limits: Limits on how much medication you can get at a time.
  • Step therapy: You must try one or more similar, lower cost drugs before the plan will cover the prescribed drug.
2016 Part D