2022 Updates for the Medicare Rx Options

Medicare requires that all Medicare prescription drug plans (including those provided by a Medicare Advantage plan) make certain changes each year. For 2022, these changes include:

• Increasing the dollar thresholds for reaching the Coverage Gap and Catastrophic Coverage to $4,430 and $7,050 respectively.
• If you meet the Catastrophic Coverage threshold, you pay: ­
  • Generic drugs: the greater of 5% or $3.95, up to the maximum ­
  • Brand-name drugs: the greater of 5% or $9.85, up to the maximum

In addition, the Value Medicare Rx Option’s annual deductible is now $480. Otherwise, there are no changes to the copay or coinsurance you pay for medication in the Initial Coverage stage under the Enhanced, Basic, or Value Medicare Rx Option.