Over 169,415 Rhode Island residents have enrolled in Medicare Part D plans. Of these enrollees, 74,385 decided on standalone prescription drug plans, and 96,178 enrolled in Medicare Advantage prescription drug plans.

These numbers increase yearly as more people qualify for Medicare and seek to manage their healthcare costs.

Rhode Island Medicare Part D Plans for 2023

While original Medicare insurance (Medicare Parts A and B) covers your doctor and hospital visits, it does not cover prescription costs. Medicare Part D is not part of Original Medicare but is within the purview of private insurance companies (carriers) to help cover those costs. Carriers offering this insurance include Wellcare, Cigna, and UnitedHealthcare.

This article aims to help Rhode Island residents become aware of their coverage options, including companies that offer Part D plans with low premiums, zero-dollar deductibles, gap coverage, and low-income subsidies.

Part D Plans With the Lowest Premiums in Rhode Island

Beneficiaries pay premiums to keep coverage under a policy, like Humana’s premium at $22.70 per month. Their deductible is $480, meaning the plan will begin paying out after you pay the first $480 in prescription costs out of pocket. They have a four-star rating.

For a lower monthly premium, consider Wellcare at $13 a month. However, the star rating indicating the plan’s effectiveness decreases to three, and the deductible is still $480. However, the $13 monthly premium will be more affordable in many circumstances as each dollar counts, similar to Aetna’s $7.40 premium at the same deductible and star rating.

For a lower deductible in exchange for a higher premium, consider UnitedHealthcare for $29.30 a month. The deductible lowers to $310.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
Aetna $7.40 $480 3 No
Wellcare $13.00 $480 3 No
Humana $22.70 $480 4 No
UnitedHealthcare $29.30 $310 4 Yes
Cigna $32.10 $480 3 No

Part D Plans With Zero-dollar Deductibles in Rhode Island

Plans in this table have a zero-dollar deductible, so the premiums are higher in exchange for not needing to pay any money before the plan starts to pay out. For example, Aetna has gap coverage with a $72.50 monthly premium and a three-star rating.

Wellcare has a lower premium at $69 per month with the same star rating. However, it lacks gap coverage, which would provide discounts during the coverage gap period explained below.

Blue MedicareRX offers gap coverage for a $136.20 monthly premium with a higher star rating. Like the other plans, it has no deductible and begins paying for prescriptions immediately.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
Wellcare $69.00 $0 3 No
Aetna $72.50 $0 3 Yes
UnitedHealthcare $101.00 $0 3 Yes
Blue MedicareRX $136.20 $0 4 Yes

Part D Plans With Gap Coverage in Rhode Island

Part D plans with gap coverage provide discounts on your prescriptions once you reach the coverage gap phase, explained further below. Carriers like UnitedHealthcare offer gap coverage for $29.30 a month with a $310 deductible.

Blue MedicareRX offers a zero-dollar deductible plan for $136.20 monthly with the same star rating. This plan includes gap coverage and an immediate start for it to pay prescription costs.

Aetna’s $72.50 premium has a lower star rating than the other two plans. However, it has a zero-dollar deductible and gap coverage.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
UnitedHealthcare $29.30 $310 4 Yes
Cigna $55.60 $100 3 Yes
Aetna $72.50 $0 3 Yes
UnitedHealthcare $101.00 $0 3 Yes
Blue MedicareRX $136.20 $0 4 Yes

Part D Plans With Low-income Subsidies in Rhode Island

If you cannot pay premiums, you may be one of the 46,384 Rhode Islanders who qualify for a Part D plan with a low-income subsidy to assist with premiums, deductibles, coinsurance, and copayments. Because of the assistance provided, premium prices do not vary much, as with Wellcare’s $33.50 monthly premium and $480 deductible.

Aetna’s premium is slightly higher at $33.60 per month with the same deductible price. Low-income subsidy plans like this do not have a coverage gap, so they do not include gap coverage.

These rules apply regardless of the carrier, like UnitedHealthcare, whose higher premium at $35 a month with the same deductible will still not have a coverage gap. The main difference is its four-star effectiveness rating.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
Wellcare $33.50 $480 3 No
Cigna $33.50 $480 3 No
Aetna $33.60 $480 3 No
UnitedHealthcare $35.00 $480 4 No
Elixir $36.10 $480 3 No

Amount of Beneficiaries That Fall Into Each Part D Coverage Phase in Rhode Island

Medicare Part D has four phases of coverage: the Deductible Phase, the Initial Coverage Phase, the Coverage Gap (Donut Hole) Phase, and the Catastrophic Phase. Prescription drug copays change depending on the phase.

The chart below shows that most Rhode Islander beneficiaries stay within the Deductible and Initial Coverage Phases.

Deductible Phase Initial Coverage Phase Coverage Gap Phase Catastrophic Phase
55,287 67,499 18,711 13,293

FAQs

Can I add Medicare Part D at any time in Rhode Island?

You can only add Medicare during one of four enrollment periods:

  • Initial Enrollment occurs the year you turn 65, including the three months before your birth month, your birth month, and the three months after
  • Open Enrollment, occurring yearly from October 15 to December 7, with coverage beginning January 1st
  • Medicare Advantage (MA) Open Enrollment, during which you can add a Medicare Part D plan to your coverage if you get or want to replace an MA plan
  • Special Enrollment occurs under unusual circumstances, such as when losing a plan or moving to an address outside of your original range

Is Medicare Part D optional or mandatory in Rhode Island?

Medicare Part D is not mandatory in Rhode Island. However, if you do not enroll in a plan once eligible for one, you may need to pay a late fee later.

The payment requirement usually occurs if you spend 63 or more days in a row with neither a Part D nor an MA plan after becoming eligible.

What are the four phases of Medicare Part D coverage in Rhode Island?

The four phases of Medicare Part D coverage are:

  • In the Deductible Phase, when you pay for prescriptions out-of-pocket
  • In the Initial Coverage Phase, when the plan starts to pay alongside copays
  • The Coverage Gap (Donut Hole) Phase, when you pay 25% of the prescription cost
  • The Catastrophic Phase, when you pay 5% of your prescription cost at maximum

The amount you pay out of pocket for your prescriptions changes depending on the phase.

How do I avoid the Medicare Part D donut hole in Rhode Island?

Reducing prescription costs is the best way to avoid the Medicare Part D donut hole. You can purchase generic brands of medication instead of brand-name versions.

Ordering prescriptions by mail may reduce costs if the pharmacy offers mail-in discounts. The Rhode Island Department of Human Services also has state-regulated prescription assistance programs.

Does Social Security automatically deduct for Part D in Rhode Island?

No, the Social Security Administration does not automatically deduct Part D premiums from Social Security checks in any state. You can have the premiums deducted from your payments after filling out a form.

How To Get Help Signing Up for a Medicare Part D Plan in Rhode Island

Technical language and complex policy requirements often complicate the process of obtaining Medicare Part D. We are here to help!

Our agents give details on the Part D options for all carriers and help you compare potential plans to make a confident decision. Their help is completely free to you!

So give us a call or fill out our online rate form to receive the best rates in your area of Rhode Island.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.