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This issue brief provides an overview of the Medicare Part D stand-alone prescription drug plan options available in 2015 and key changes from prior years. The analysis examines Part D plan availability, premiums, benefit design features, and low income subsidy plan availability.
The 2014 Part D Data Spotlight analyzes information about the Medicare Part D stand-alone prescription drug plan (PDP) options available to beneficiaries in 2014. The analysis shows that Medicare beneficiaries on average will have a choice of 35 stand-alone prescription drug plans in 2014, and somewhat more “benchmark” plans available to Low-Income Subsidy (LIS) beneficiaries nationwide. The weighted average premium will increase by 5 percent between 2013 and 2014 if enrollees remain in the same plans next year. The analysis also finds more plans are using preferred pharmacy networks and adopting a growing number of cost-sharing formulary tiers for different drugs.
This analysis finds that relatively few Medicare beneficiaries have switched Part D prescription drug plans voluntarily during the annual open enrollment period -- even though those who do switch often lower their out-of-pocket costs as a result of changing plans. The vast majority (87% on average between 2006 and 2010) stayed in the same Part D plan, even though the plans can change premiums, deductibles, cost-sharing amounts, and their list of covered drugs each year. Higher rates of plan switching were observed in PDPs that increased premiums, increased deductibles, or dropped coverage of brand-name drugs in the coverage gap.
This Data Spotlight reviews national and state-level enrollment trends as of March 2017 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.
This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government's online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor's offices and pharmacists. After they enroll in a plan, many seniors did not revisit their initial decision or review plan options without the strong provocation of a substantial increase in cost, change in coverage, or shift in personal health care needs. Moreover, they feared that a change in plans may disrupt their care, or lead to an unforeseen increase in out-of-pocket costs, and require them to learn new rules and requirements. They are doubtful they would end up in a plan that is appreciatively different or better for them. Overall, seniors preferred to have numerous choices in plans but would like personalized help and advice from experts to ease the process.
This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, focusing on the views of people under age 65 with physical and/or mental disabilities. Supplemental Chartpack (.
This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals under consideration to provide outpatient prescription drug coverage to Medicare beneficiaries. It includes both a summary and a detailed comparison of the following major proposals: S. 357, The Medicare Preservation and Improvement Act of 2001 (Breaux/Frist I), S.
This Part D Data Spotlight documents the wide variations across the private stand-alone drug plans with respect to coverage of drugs, what enrollees pay for those drugs, and restrictions and limitations placed on their use. These variations have potentially significant implications for beneficiaries’ access to medications and out-of-pocket costs.
This policy brief describes the financing of Illinois' new Medicaid prescription drug waiver.
Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years.
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