A comprehensive Kaiser Family Foundation report analyzes key trends that have shaped the Medicare Part D marketplace since the program launched nine years ago. Some of their findings include the following:
- Part D plan premiums range from $12.80 per month to $111.40 per month for plans offering the basic Part D benefit.
- Premiums for older, established plans have generally increased more rapidly than the national average, while newer plans tend to enter with relatively low premiums in order to build enrollment.
- As a result, beneficiaries who stay in the same plan tend to pay more over time, and earlier research finds that relatively few enrollees switch plans voluntarily in a given year.
- In 2014, 72 percent of stand-alone plans include a preferred pharmacy network, which offers the lowest cost sharing for enrollees. This represents a sharp increase since 2011, when just 7 percent of plans used preferred pharmacy networks.
- About 11 million enrollees with low incomes receive extra help through the Low-Income Subsidy program, which reduces their cost sharing, and fully or partially covers their drug plan premiums if they are enrolled in designated plans. However, about 1.3 million low-income enrollees are enrolled in higher-cost stand-alone plans, and are paying a premium, averaging $17.85 per month, more than in any previous year. While some of these enrollees may be choosing to stick with their current plans, and pay monthly premiums, others may be unaware that there are plans available to them at no cost.
People can change their Part D plan during the Open Enrollment Period (October 15 – December 7).
To identify the right plan based on the prescriptions you take, go to Medicare.gov. Put in your prescriptions, your pharmacy, and then check the first box for “Prescription Drug Plans (with original Medicare)”. In Arizona, we have 32 Part D plans to choose from. I recently wrote about Walter, who is paying $53 for his Part D plan when he should be paying about $14, based on his prescriptions.
The prevalence of “preferred pharmacies” makes using Medicare.gov a bit challenging. How do you know if the pharmacy you use is “preferred” by the drug plan you might choose.? Medicare.gov requires you to select a pharmacy and that will skew the results if you put in CVS as our pharmacy and Walgreens is “preferred” by several plans. As an insurance broker, I know that Walgreens is “preferred” by certain Part D plans while Walmart is preferred by others. I usually go through the plan selection several times while changing the chosen pharmacy – and it definitely changes the order of the search results.