Medicare Part D: A First Look at Plan Offerings in 2016

Introduction
  1. These enrollment counts include nearly 7 million Part D enrollees in employer-only plans, not otherwise analyzed for this spotlight.

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  2. Centers for Medicare and Medicaid Services, “Medicare Advantage Premiums Remain Stable; Enrollment at All-Time High,” September 21, 2015; 2016 PDP, MA, and SNP Landscape Source Files and related files are available at http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/.

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  3. For analysis of the 2015 Part D marketplace and ten-year trends, see Jack Hoadley, Juliette Cubanski, and Tricia Neuman, "Medicare Part D at Ten Years: The 2015 Marketplace and Key Trends, 2006-2015," Kaiser Family Foundation, October 2015, available at https://www.kff.org/medicare/report/medicare-part-d-at-ten-years-the-2015-marketplace-and-key-trends-2006-2015/; analysis of the Part D marketplace for earlier years is available at https://www.kff.org/.

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Findings
  1. The average is weighted by enrollment.

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  2. Gretchen Jacobson, Anthony Damico, and Tricia Neuman, “What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2016,” Kaiser Family Foundation, October 2016.

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  3. In addition, two PDPs offered by First Health (Aetna) changed contract numbers.

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  4. Based on authors' analysis using the CMS 2016 Part D Crosswalk file.

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  5. During 2015, the average premium continued to drop, most likely due to plan elections by newly eligible beneficiaries, who are likely to enroll in plans with below-average premiums. The average PDP premium fell from $37.20 in February to $37.02 in April to $36.68 in September, a net drop of 1 percent in seven months.

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  6. The average premium will increase from $28.18 in 2015 to $30.41 in 2016 for basic-benefit PDPs and will increase from $47.15 to $55.06 for enhanced-benefit PDPs. Enrollees in 37 PDPs will switch from enhanced to basic, but excluding them does not affect the rates of increase.

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  7. CMS, “Medicare Prescription Drug Premiums Projected to Remain Stable”, available at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-07-29.html.

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  8. Jack Hoadley, Juliette Cubanski, and Tricia Neuman, "Medicare Part D at Ten Years: The 2015 Marketplace and Key Trends, 2006-2015," Kaiser Family Foundation, October 2015, available at https://www.kff.org/medicare/report/medicare-part-d-at-ten-years-the-2015-marketplace-and-key-trends-2006-2015/.

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  9. Centers for Medicare & Medicaid Services, “Annual Release of Part D National Average Bid Amount and Other Part C & D Bid Related Information,” July 29, 2015.

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  10. Juliette Cubanski and Tricia Neuman, “Medicare's Income-Related Premiums: A Data Note,” June 2015, available at https://www.kff.org/medicare/issue-brief/medicares-income-related-premiums-a-data-note/.

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  11. These calculations are made from the Plan Finder for one region and cover only national and near-national plans.

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  12. This amount corresponds to the estimated catastrophic coverage limit for non-Low-Income Subsidy enrollees ($7,063 for LIS enrollees), which corresponds to True Out-of-Pocket (TrOOP) spending of $4,850 (the amount used to determine when an enrollee reaches the catastrophic coverage threshold).

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

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  14. 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 number to be reassigned will be released by CMS in November or December 2015.

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

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  16. 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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  17. Jack Hoadley, Laura Summer, Elizabeth Hargrave, Samuel Stromberg, Juliette Cubanski, and Tricia Neuman, “To Switch or Be Switched: Examining Changes in Drug Plan Enrollment among Medicare Part D Low-Income Subsidy Beneficiaries” Kaiser Family Foundation, July 2015, available at https://www.kff.org/medicare/report/to-switch-or-be-switched-examining-changes-in-drug-plan-enrollment-among-medicare-part-d-low-income-subsidy-enrollees/.

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