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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.
This report presents findings from an analysis of the Medicare Part D marketplace in 2013 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan availability, enrollment, premiums, low-income subsidies, the coverage gap, benefit design, cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by researchers at Georgetown University, the Kaiser Family Foundation and the National Opinion Research Center at the University of Chicago.
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 short Kaiser Family Foundation documentary profiles the experiences of three Medicare families trying to pay for their health care costs with other household spending. The families are among 16 featured in a companion report examining the role Medicare now plays in the lives of beneficiaries and the challenges many face in paying for their health care and other living expenses on a fixed budget.
This Part D Data Spotlight examines key differences between basic and enhanced Medicare stand-alone prescription drug plans (PDPs), including monthly premiums, cost sharing, and gap coverage. It also examines plan names to assess whether they convey meaningful differences between basic and enhanced PDPs.
This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2008. Part D enrollees (other than those receiving low-income subsidies) will reach the coverage gap after they incur $2,510 in total drug costs in 2008.
In a few short weeks, Medicare will undergo big changes that will have a major impact on nearly 4 million African American seniors and younger people with permanent disabilities who rely on Medicare for their health coverage.
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