Part D Bid and Base Premium Will Drop in 2023; MA-PD Enrollment Surpasses PDP for the First Time in 2022

The monthly Medicare Part D base beneficiary premium for 2023 will be $32.74, a slight decrease from $33.37 in 2022, according to CMS. The Part D national average monthly bid amount continues to drop, from $38.18 in 2022 to $34.71 in 2023. Regional low-income premium subsidy amounts have increased over the past few years in most states, yet five states — New York, Illinois, New Jersey, Indiana and Kentucky — are projected to see a decline larger than 5% in 2023. South Carolina is projected to see the biggest jump, with its average subsidy amount going up from $31.12 in 2022 to $37.84.

In 2022, about 48.9 million Medicare beneficiaries are enrolled in Stand-Alone Prescription Drug Plans (PDPs) or Medicare Advantage Prescription Drug Plans (MA-PDs), according to a recent Kaiser Family Foundation analysis. This is the first year that MA-PD enrollment (25.8 million) surpassed PDP enrollment (23.1 million). Almost 26% of all Part D enrollees receive a low-income subsidy in 2022, while nearly six in 10 LIS-enrollees are covered by MA-PDs.

The top three Part D insurers by market share — UnitedHealth Group, Humana Inc. and CVS Health Corp. — currently account for 57% of enrollment. More than half of UnitedHealth and Humana’s Part D enrollees choose MA-PDs, while CVS Health has greater enrollment in PDPs.

In 2022, the enrollment-weighted average monthly premium for PDPs is $39.87, a 4% increase from the weighted average premium in 2021, whereas the enrollment-weighted average monthly portion of the premium for drug coverage in MA-PDs is only $10.77. Meanwhile, the enrollment-weighted average deductible for PDPs reached almost $400 in 2022, nearly 4.5 times larger than the average deductible in MA-PDs.

NOTES: MA-PD enrollment includes Medicare Advantage HMOs, PPOs, private fee-for-service and Medicare Savings Account plans; other Medicare private plans (including Medicare-Medicaid plans, Cost, and PACE) are excluded. BCBS excludes Anthem BCBS, which is a separate plan sponsor. The average premium for MA-PDs is for Part D coverage only, excluding any applicable premium charged for medical (Part A and B) benefits.

SOURCES: CMS. “Key Facts About Medicare Part D Enrollment and Costs in 2022,” Kaiser Family Foundation.

This infographic was reprinted from AIS Health’s biweekly publication RADAR on Drug Benefits.