Claeys Group Insurance Services - Tyler, TX

A Change in Your 2023 Medicare Part D Deductible

As we might expect, there will be a change in costs with Medicare Part D prescription drug plans for 2023. So what will this mean for you?

If you have had a Medicare Part D prescription drug plan in 2016, you will notice some changes in your drug plan for 2017. First of all, the annual deductible on Medicare Part D plans will rise from $360 to $400.

Not all plans have a deductible in 2016, but most do; and those that do have a deductible of $360.  Next year, any plan with a deductible will make you pay $400 out of pocket before entering the initial coverage part of your plan.

Are there any other changes in store for Part D coverage in 2023? (I’m glad you asked.) Yes, there are. In fact, there are actually some changes that can benefit you.

Understanding Your 2023 Medicare Part D Changes

Before we look at those changes, it is important to have a basic understanding of how a Medicare Part D prescription drug plan works. There are four main parts to a Medicare Part D plan; 1) the deductible; 2) the initial coverage phase; 3) the coverage gap (donut hole); and 4) the catastrophic phase.

Your Medicare Part D Coverage Gap / Donut Hole

We have already touched on the deductible. The coverage gap, or donut hole, of the plan is where your costs will rise significantly. (For more on this, see the Medicare Part D donut hole.) The retail costs of your medications during your deductible, added to the retail costs of your medications during your initial coverage period, count toward reaching the coverage gap. In 2016, once your retail costs hit $3,310, you would enter the coverage gap where you would pay a lot more for your medications.

Once your retail costs hit $4,850 in 2016, you would enter the third phase of the plan, the catastrophic phase. During this phase, your medication costs would drop drastically from the costs you pay during the coverage gap.

How You Enter the Donut Hole on Your Medicare Part D Plan

It is important to note the key phrase in the above descriptions; this critical term is “retail costs.” These costs are not based on what YOU pay; instead, they are measured by the retail listings of your medications. Allow me to illustrate.

Suppose you purchase a medication with your plan that has a retail value of $100, but your copay is only $25. It is the $100 retail value—not the $25 copay—that is added to determine where you are in your initial coverage period or how close you are to reaching the donut hole / coverage gap. So, while the 2016 initial coverage limit is $3,310, you may only pay for 25% of that amount prior to hitting the donut hole.

Similarly, while the percentage of retail cost you pay goes up during the coverage gap / donut hole, you would not pay the entire amount of the gap (from $3,310 to $4,850); instead, you would pay 45% of name brand costs and 58% of generic costs until the retail cost hits $4,850. Once you hit $4,850 in 2016, you reach the catastrophic phase where your costs significantly drop. (You would pay around 5% of the cost during this phase.)

To summarize, you pay 100% of the retail cost of your medications during your deductible, around 25% of the retail cost during the initial coverage phase, around 50% of the retail cost during the coverage gap, and about 5% of the retail cost during the catastrophic phase. Now that we understand the basics, we can look at the changes in Medicare Part D drug plans for 2017.

2023 Changes that Will Benefit You in Your Medicare Part D Plan

As we have already noted, the annual deductible on Medicare Part D prescription drug plans will move from $360 to $400, a $40 difference. That, of course, is not a positive change for you.

However, one adjustment that could benefit you is that the initial coverage limit will move from $3,310 in 2016 to $3,700 in 2017. The possible benefit you may experience on this change is that it will take you longer to reach the dreaded donut hole (coverage gap), where your medication costs would rise significantly. This, of course, saves you money (and that’s always good).

Another change coming for 2023 is that the range on the coverage gap will be from $3,700 to $4,950. That is a spread of $1,250, shrinking the donut hole by $290 from 2016 to 2023. If you have to experience the donut hole, then it is better to share in $1,250 of it than to split $1,540 (the 2016 share of it). So, this is another change that could save you money. (And we like that!)

Can You Save Even More Money?

While these changes can save you money, there are things you can do to save even more money on your medications in 2023. First, if you can, switch to generics. Granted, not all medications have a generic equivalent, but switching to lower-cost alternatives on your medications could keep you from entering the donut hole on your coverage.

Second, make sure you get the 2023 plan that fits your medications in the best way. Don’t make the mistake of choosing a plan based solely on its premium or on its deductible. The best plan for you depends on the combination of medications you take. Have your insurance agent (the one who helped you get a Medicare supplement) shop your medications for you. Getting the right plan will definitely save you money. (See how to find your best Part D drug plan.)

Third, if you qualify for “Extra Help” or Low Income Subsidy (based upon income—which, for 2016, is $17,665 for a single person and $23,895 for a married couple living together in 2016—and assets), you will avoid the coverage gap. This federal program also pays the deductible of a Medicare Part D plan, and it shares medication costs. If you think you may qualify, you can apply for this program online at, or you can call your state’s Medicaid office or the Social Security Administration.

If you don’t qualify for “Extra Help,” you still may be eligible for financial assistance from the manufacturer of any brand-name medication you take. Visit to find out if there’s a Pharmaceutical Assistance Program for the medications you take.

There are also state pharmaceutical assistance programs available, depending on where you live. Again, visit to find out if your state has a program.

The Takeaway for Medicare Part D Drug Plans

Remember: Any savings are good savings. Why spend more than you need to spend on your medications in 2023? In fact, here’s to a more prosperous 2023 for you.

Linda WilliamsLinda Williams
10:08 12 Jul 23
I had a 5 star experience and would recommend him. Always returning my calls promptly, very helpful and informative, listened to what my needs was regarding my Medicare. I truly felt comfortable with John's help to navigate through the maze of Medicare
Cindy KulakCindy Kulak
14:51 18 Jun 23
John is very knowledgable, honest and ethical in helping clients evaluate Medicare options and get enrolled. He made the process extremely easy for myself and my husband.
Leeann MoosLeeann Moos
17:26 06 Apr 23
When I became eligible for Medicare, my phone was constantly under attack from Medicare options sales folk. Since I needed help understanding my options and life is too short to do business with annoying people a little research was in order. Thats how I found John. His other customers seem very pleased with his service and I decided to give him a try. I was NOT disappointed! He did an excellent job for me, is extremely personable and I could not be happier. Thank you John
Rose WrightRose Wright
16:07 05 Apr 23
I am so thankful for the help that Mr. John was able to assist me with medicare information. After being bombarded with letters and phone calls you just need someone who can walk you through the confusion. And after getting all the info and the best plan and benefits for what i needed. I am glad that He was there for me.Thank you so very much,Rose Wright
Steve HenselSteve Hensel
21:08 04 Apr 23
Claeys Group is great to work with. John is truly professional, knowledgeable and makes the entire process flow so much more smoothly than I expected. I would highly recommend him.
Deborah RounsavallDeborah Rounsavall
14:25 07 Mar 23
I changed from my person finance planning group to John for help. Others led me astray. John is very responsive and follows up promptly. Even helped me on the weekend at the end of year to get all my documents in on time so I didn't lose insurance coverage. Explains all the options in a manner that us rookies can understand it. I highly recommend John.
Setella ParksSetella Parks
13:12 07 Mar 23
John's knowledge is invaluable when it comes to navigating the murky water of Medicare plans. He answered all our questions in a manner we could understand and helped us compare benefits between plans, services, and providers readily available in our area. I am so happy we called on him to assist us! He handled EVERYTHING professionally and patiently and has followed up to make sure we are good. Highly recommend his 5 star service!
Sherry JonesSherry Jones
21:01 23 Feb 23
John was recommended by my sister-in-law, who spoke very highly of him. He wrote out the differences between policies and explained it step by step to me so I could understand which policy would be best for my needs. He was professional but also down to earth so I could be at ease. He did this at my bed side which was such a blessing for me. I highly recommend John for your Insurance needs.
19:40 20 Feb 23
We were recommended by friends to call John Claeys for our insurance. He came twice to gather information on what we were looking for and returned with information and details. We are delighted to have John Claeys as our agent and would recommend to our friends and anyone else to call John Claeys today.Tom and Debbie
Joyce SandvikJoyce Sandvik
20:32 30 Aug 22
John Claeys came to our house to talk about all aspects of Medicare. He wrote out some information on a notepad as he talked and answered our questions. He gave us the handwritten notes along with printouts of more information specific to my needs. My husband and I took o a few days to discuss the options. John took a list of my medications and researched all the available prescription insurance policies for me. He narrowed it down to the best policy (best prescription prices) for me. It was so easy and I felt confident I was getting exactly what I need when I turn 65. Every September, he will research prescription policies from my updated list of medications to find the best policy for my needs. Thanks to John Claeys for making this transition extremely easy and effortless.
Marilyn ScottMarilyn Scott
09:35 23 Jul 22
John enrolled my husband into Medicare 4 years ago. I knew then I wanted him to help me with my Medicare when it was my time to enroll. John helped me recently. He is very knowledgeable, humble and so patient. He made sure I had the best plan for me. He genuinely cares about his clients. He is the best insurance consultant! I highly recommend John for your Medicare needs!!
James MartinJames Martin
20:31 20 Jun 22
John did a great job of providing many options for my insurance. He is very thorough.
Judy MarkmanJudy Markman
17:02 20 Jun 22
John goes above and beyond to find the best insurance to fit your needs at an affordable price. I definitely recommend!
Dave LemingDave Leming
16:56 20 Jun 22
John was referred to my wife and I as we began to transition to use Medicare as our insurance options. He was very knowlegeable about all things related to government programs and supplemental options as well. I would strongly recommend his services to anyone requiring such support.
Ed HareEd Hare
14:16 08 Jun 22
John was recommended to us by a friend as we were turning 65 and having to make decisions on our medicare and advantage plan choices.John was thorough, informed, patient and engaged in helping us wade through all the minutia we were receiving to package the best set of programs for our future healthcare needs.We are happy and confident as healthcare needs arise having John at our side.Debi and Ed Hare
Julie SimpsonJulie Simpson
02:36 14 May 22
We selected an awesome advisor in John Claeys! John was dedicated to our needs in counseling our new Insurance choices with Medicare. He is sincere in getting his customers into the program that is best for their situation. John was sincere in explaining the process and we are happy to refer him to others! Steve and Julie Simpson
Sherry HilliardSherry Hilliard
16:55 18 Feb 22
John was extremely helpful when I had to select my Medicare supplemental policy. He is very knowledgeable in the various insurance products. I would recommend John to anyone needing insurance, and in fact, I have recommended him to several of my friends.
Margie SmithMargie Smith
01:08 16 Feb 22
Highly recommend Claeys Group Ins Service, John has assisted with my Medicare supplement and RX choices for past couple years. He is very knowledgeable of the various companies and policies available. Saved money and introduced me with a 5star company.
16:56 10 Feb 22
John came to my house and explained the process of signing up to Medicare in an understandable way. He gave me the steps to take and assisted in the planning. With his help, I got it done. Before he came, it all seemed overwhelming. He's so genuinely nice, and I felt like I had known him for a long time. I highly recommend him, and in fact, already have recommended him to friends and family.
Rebecca NelsonRebecca Nelson
21:00 04 Feb 22
John Claeys is a great individual to work with you on insurance needs. He searched out the best policy and an affordable one that I could handle. He researches every year to be sure I’m getting the most for my money! Highly recommend this group.
Dorys GardensDorys Gardens
12:20 23 Jan 22
John was so pleasant to work with. He explained everything clearly and did not pressure me to make a decision one way or the other. He shopped for the best customized drug plan which will be saving me money in the long run. I highly recommend letting him guide you through the medicare process.

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