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Medicare Part D: A First Look at Plan Offerings in 2015

Introduction
  1. Centers for Medicare and Medicaid Services, “Medicare Advantage enrollment at all-time high; premiums remain affordable,” September 18, 2014; 2015 PDP, MA, and SNP Landscape Source Files and related files are available at http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/.

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  2. These enrollment counts from September 2014 include 6.6 million Part D enrollees in employer-only plans, not otherwise analyzed for this spotlight.

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  3. Analysis of the 2014 Part D marketplace is available at https://www.kff.org/medicare/report/medicare-part-d-in-its-ninth-year-the-2014-marketplace-and-key-trends-2006-2014/ and https://www.kff.org/medicare/issue-brief/medicare-part-d-a-first-look-at-plan-offerings-in-2014/; analysis of the 2013 Part D marketplace is available at https://www.kff.org/medicare/issue-brief/medicare-part-d-prescription-drug-plans-the-marketplace-in-2013-and-key-trends-2006-2013/ and https://www.kff.org/medicare/report/medicare-part-d-first-look-at-2013-plan-offerings/. Analysis of the Part D marketplace for earlier years is available at https://www.kff.org/.

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Key Findings
  1. The average is weighted by enrollment.

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  2. Based on authors' analysis using the CMS 2015 Part D Crosswalk file.

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  3. The average premium will decrease from $29.25 in 2014 to $29.10 in 2015 for basic-benefit PDPs and will increase from $47.90 to $51.43 for enhanced-benefit PDPs. However, enrollees in 33 PDPs where beneficiaries are reassigned due to plan consolidation will switch from a basic PDP to an enhanced PDP, and enrollees in 68 PDPs will switch from enhanced to basic. If those enrollees are excluded, enrollees in basic PDPs will have on average a 3.8 percent premium increase, while those in enhanced PDPs will have a 7.5 percent increase.

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  4. Centers for Medicare & Medicaid Services, “Annual Release of Part D National Average Bid Amount and Other Part C & D Bid Related Information,” July 31, 2014.

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  5. Juliette Cubanski et al., “Raising Medicare Premiums for Higher-Income Beneficiaries: Assessing the Implications,” February 2012, available at https://www.kff.org/medicare/issue-brief/income-relating-medicare-part-b-and-part/.

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  6. This amount corresponds to the estimated catastrophic coverage limit for non-Low-Income Subsidy enrollees ($6,680 for LIS enrollees), which corresponds to True Out-of-Pocket (TrOOP) spending of $4,700 (the amount used to determine when an enrollee reaches the catastrophic coverage threshold).

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  7. Plans qualifying through the de minimis policy are eligible for new enrollees, but will not receive auto-assigned enrollees.

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  8. Estimates for the total number of beneficiaries subject to paying a premium are based on plan data from the landscape and crosswalk files, together with CMS enrollment reports. The estimate of the number scheduled to be reassigned is based on personal communication from CMS; a final number will be released by CMS in November 2014.

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  9. These counts of benchmark plans include those designated as de minimis plans, which will not receive auto-assigned enrollees.

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  10. CMS has modified the terminology for what were previously called preferred pharmacy networks. Jack Hoadley, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and Tricia Neuman, “Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends,” Kaiser Family Foundation, August 2014, available at https://www.kff.org/medicare/report/medicare-part-d-in-its-ninth-year-the-2014-marketplace-and-key-trends-2006-2014/.

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  11. Jack Hoadley, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and Tricia Neuman, “Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends.”

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  12. Jack Hoadley, Elizabeth Hargrave, Laura Summer, Juliette Cubanski, and Tricia Neuman, "To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Money?" Kaiser Family Foundation, October 2013, available at https://www.kff.org/medicare/issue-brief/to-switch-or-not-to-switch-are-medicare-beneficiaries-switching-drug-plans-to-save-money/.

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