Through the Part D Low-Income Subsidy (LIS) program, additional premium and cost-sharing assistance is available for Part D enrollees with low incomes (less than 150% of poverty, or $20,395 for individuals/$27,465 for married couples in 2022) and modest assets (up to $15,510 for individuals/$30,950 for couples in 2022). Low-Income Subsidy Plan Availability in 2023īeneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. Under the new Inflation Reduction Act requirement, all Part D plans do not have to cover all insulin products at the $35 monthly copayment amount, only those insulin products that are covered on a plan’s formulary. While this model will continue in 2023, beneficiaries will not need to enroll in one of the model-participating plans to benefit from the $35 monthly copay cap for insulin. In 2023, a total of 2,881 Part D plans will participate in this model, including 324 PDPs and 2,557 MA-PDs. This new requirement builds on a current Innovation Center model in which only participating enhanced Part D plans cover insulin products at a monthly copayment of $35 in the deductible, initial coverage, and coverage gap phases of the Part D benefit. In 2023, under a provision in the Inflation Reduction Act, Part D enrollees will pay no more than $35 per month for covered insulin products in all Part D plans. In 2023, 801 PDPs will be offered across the 34 PDP regions nationwide (excluding the territories), a 5% increase from 2022 (Figure 1). Medicare Prescription Drug Plan Availability in 2023 It also provides an overview of upcoming changes to the Part D benefit based on provisions in the Inflation Reduction Act. This fact sheet provides an overview of the Medicare Part D program, plan availability, enrollment, and spending and financing, based on data from the Centers for Medicare & Medicaid Services (CMS), the Congressional Budget Office (CBO), and other sources. In 2022, 49 million of the 65 million people covered by Medicare are enrolled in Part D plans. Beneficiaries can choose to enroll in either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare or a Medicare Advantage plan, mainly HMOs and PPOs, that provides all Medicare-covered benefits, including prescription drugs (MA-PD). Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans that contract with the federal government.

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