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Beyond the Numbers:

Massachusetts’s 2009 Medicare Part D plan choices in plain text

Based on the 2009 Medicare Part D plan information released by the Centers for Medicare and Medicaid Services (CMS), Massachusetts seniors and Medicare beneficiaries will find that 2009 will bring a number of changes to prescription drug coverage and they should be prepared to examine their current 2008 plans closely to see what changes are on the horizon for 2009.

Please note that the information we provide below is based only on stand-alone Medicare Part D prescription drug plans (or PDPs).  As many people know, a number of the Medicare Advantage plans also include comprehensive prescription drug coverage, along with Medicare Part A (hospitalization) and Medicare B (physician) benefits (also called MA-PD plans).  However, because MA-PDs include many additional features (including Part A & B coverage) as compared to a stand-alone Medicare Part D plan, we do not try to compare the stand-alone drug plans directly with MA-PDs.

What is new for 2009 Medicare Part D Prescription Drug Plans?

First, the number of prescription drug plans available in Massachusetts has decreased.
Across the country, 16 companies will offer 2009 Medicare Part D plans on a national basis.  In addition, a wide assortment of regional and local Medicare Part D plans are offered within each state or CMS region, with the average number of prescription drug plans offered per state decreasing from 53 plans in 2008 to 49 plans in 2009.

Locally, Massachusetts residents will find that the total number of stand-alone Medicare prescription drug plans has decreased from 51 in 2008 to 47 in 2009.

As a note, if you find that your current 2008 Part D plan is not being offered in 2009, you may wish to review your Part D plan’s Annual Notice of Change (or ANOC) letter to see if you will be automatically moved to another 2009 prescription drug plan or whether you will need to actively choose a new Medicare Part D plan for 2009.

91% of Massachusetts seniors can expect to see their monthly prescription drug plan premiums increase in 2009.
Across the country, the national average monthly Medicare Part D premium will increase from $40.02 in 2008 to $45.46 in 2009.  Based on the 2008 enrollment figures, 88% of Medicare Part D beneficiaries nationwide (over 14 million people) could experience an average increase in premium of $8.23, unless they switch to a lower priced plan.  At home, Massachusetts residents will also notice an increase in their Medicare Part D premiums.  91% of Massachusetts seniors and other Medicare beneficiaries enrolled in a stand-alone Medicare Part D plan, (or around 603,792 people) will see an average increase in monthly premiums of $7.97 in 2009 -- if they do not switch to a lower cost prescription drug plan.  Overall, monthly 2009 prescription drug plan premiums in Massachusetts will increase 5.81% from a 2008 average monthly cost of $40.71 to a 2009 average Part D plan premium of $46.52.

The average monthly premiums discussed above treat all Medicare Part D plans equally.  Perhaps a more telling average is the weighted average - that is, looking at each plan’s monthly premium based on number of people enrolled in that plan.  Based on the weighted average, Massachusetts residents can expect to see a 18% increase in their monthly premiums. This means that if everyone stays in their current 2008 prescription drug plan through 2009, then across the state we can expect beneficiaries to pay 18% more for their monthly premium.

The range of monthly drug plan premiums will decrease.
Across the country, 2009 Medicare Part D plan premiums range from a low of $10.30 (First Health Part D-Secure in NM) to a high of $136.80 (Aetna Medicare Rx Premier in NY) .  Comparatively, the premiums within Massachusetts will range from $19.40 (First Health Part D-Secure in CT MA RI VT) to $111.30 (Aetna Medicare Rx Premier in CT MA RI VT) - as compared to the 2008 Massachusetts monthly premium range of $14.60 to $99.50.  Of those 2009 plans, 1 plans will have a premium under $20 (in 2008, 2 Part D plans were offered in Massachusetts with a premium under $20). 

Fewer Medicare prescription drug plans will offer some level of coverage gap protection.
The selection of prescription drug plan coverage options has also changed with fewer companies offering 2009 Part D plans with donut hole coverage.  In 2008, 15 plans offered plans with some form of donut hole coverage and in 2009 that number will decrease to 12.  People are reminded to see what drugs are actually covered in the donut hole because some Part D plans only cover a "few" drugs through the coverage gap.

The same number of Medicare prescription drug plans will offer plans with enhanced options.
Massachusetts residents will find that 26 Part D plans will offer enhanced prescription drug coverage options.  Enhanced Medicare Part D coverage includes prescription drug plans that have a lower or no initial deductible and a variation of cost-sharing (for instance, copayments instead of co-insurance).  For example, in 2009, fewer Massachusetts Part D plans will offer prescription drug coverage with a $0 initial deductible (27 in 2009 as compared to 31 in 2008).

Low-Income Subsidy Recipients in Massachusetts will have less Part D plans that qualify for the $0 monthly premium.
Massachusetts Medicare beneficiaries who qualify for full "Extra Help" will find that fewer Part D plans qualify for the $0 premium Low-Income Subsidy as compared to last year.  In 2008, 14 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy as compared to 12 Part D plans in 2009.  Please note, if you received "Extra Help" in 2008 and your plan does not qualify for the $0 premium in 2009, you may be automatically moved to a new Part D plan that does qualify for the $0 premium.  If this occurs, please check to be sure that your prescriptions are covered on your new plan.  If they are not, you can switch to a plan which will cover your medications.

So what is the Bottom Line? Review your 2009 Medicare prescription drug plan options.
Massachusetts seniors and Medicare beneficiaries will see fewer prescription drug plan choices in 2009 and higher premiums. 

In addition, behind the numbers, some of 2008’s more popular Medicare Part D plans will change their 2009 plan structure.  Some plans are adding initial deductibles or changing cost-sharing limits (for instance, how much you pay after for a covered drug).  Also, some plans actually change the initial coverage limit defining when you enter the coverage gap.    It goes without saying that Massachusetts seniors could be unpleasantly surprised by the changes in 2009 plans. 

Accordingly, people are reminded to consider their 2009 prescription drug plan options carefully.  If you are a Medicare beneficiary and make no decision to change your existing prescription drug coverage, you will be automatically reenrolled in your existing prescription drug plan - along with any changes that have been made in coverage or cost for 2009.  If your prescription drug plan is discontinued, and you are not automatically moved into a new plan, then you will need to enroll in another Part D plan or not have prescription drug coverage in 2009. 

For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information.

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