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Beyond the Numbers: |
Vermont’s 2011 Medicare Part D plan choices in plain text |
| Based on the 2011 Medicare Part D plan information released by the Centers for Medicare and Medicaid Services (CMS),
Vermont seniors and Medicare beneficiaries will find that 2011 will bring a number of changes to prescription drug
coverage and they should be prepared to examine their current 2010 plans closely to see what changes
are on the horizon for 2011.
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 2011 Medicare Part D Prescription Drug Plans? |
| First, the number of prescription drug plans available in Vermont has
decreased. Most notably, some carriers have consolidated plans, most notably, the Coventry AdvantraRx Part D plans will be replaced by the Coventry First Health plans and the PrescribaRx plans will be replaced by the CCRx plans (PrescribaRx and CCRx were both provided through Universal American in 2010). The Medicare prescription drug plans from Aetna are not represented in the landscape as Aetna continues to be sanctioned by CMS. However, Fourteen (14) companies will offer 2011 Medicare Part D plans in most states across the country. 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 46 plans in 2010 to 30 plans in 2011. Locally, Vermont residents will find that the total number of stand-alone Medicare prescription drug plans has decreased from 48 in 2010 to 31 in 2011. As a note, if you find that your current 2010 Part D plan is not being offered in 2011, 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 2011 prescription drug plan or whether you will need to actively choose a new Medicare Part D plan for 2011. 42% of Vermont seniors can expect to see their monthly prescription drug plan premiums increase in 2011. Across the country, the national average monthly Medicare Part D premium will increase from $46.58 in 2010 to $53.77 in 2011. Based on the 2010 enrollment figures, 64% of Medicare Part D beneficiaries nationwide (over 8 million people) could experience an average increase in premium of $6.74, unless they switch to a lower priced plan. At home, Vermont residents will also notice an increase in their Medicare Part D premiums. 42% of Vermont seniors and other Medicare beneficiaries enrolled in a stand-alone Medicare Part D plan, (or around 247,258 people) will see an average increase in monthly premiums of $5.26 in 2011 -- if they do not switch to a lower cost prescription drug plan. Overall, monthly 2011 prescription drug plan premiums in Vermont will increase 6.50% from a 2010 average monthly cost of $49.01 to a 2011 average Part D plan premium of $55.51. 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, Vermont residents can expect to see a 6% increase in their monthly premiums. This means that if everyone stays in their current 2010 prescription drug plan through 2011, then across the state we can expect beneficiaries to pay 6% more for their monthly premium. The range of monthly drug plan premiums will decrease. Across the country, 2011 Medicare Part D plan premiums range from a low of $14.80 (Humana Walmart-Preferred Rx Plan (PDP) in WI) to a high of $133.40 (BlueRx Enhanced (PDP) in DC DE MD) . Comparatively, the premiums within Vermont will range from $14.80 (Humana Walmart-Preferred Rx Plan (PDP) in CT MA RI VT) to $120.10 (Medco Medicare Prescription Plan - Choice (PDP) in CT MA RI VT) - as compared to the 2010 Vermont monthly premium range of $10.80 to $100.80. Of those 2011 plans, 1 plans will have a premium under $25 (in 2010, 1 Part D plans were offered in Vermont with a premium under $25). The same number of Medicare prescription drug plans will offer some level of coverage gap protection. The selection of prescription drug plan coverage options has remained unchanged with the same number of companies offering 2011 Part D plans with donut hole coverage. In 2010, 10 plans offered plans with some form of donut hole coverage and in 2011 that number will remain unchanged at 10. 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. Less Medicare prescription drug plans will offer plans with enhanced options. Vermont residents will find that less Part D plans will offer enhanced prescription drug coverage options with 13 enhanced Part D plans in 2011 as compared to 25 in 2010. 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 2011, fewer Vermont Part D plans will offer prescription drug coverage with a $0 initial deductible (13 in 2011 as compared to 20 in 2010). Low-Income Subsidy Recipients in Vermont will have less Part D plans that qualify for the $0 monthly premium. Vermont 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 2010, 12 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy as compared to 11 Part D plans in 2011. Please note, if you received "Extra Help" in 2010 and your plan does not qualify for the $0 premium in 2011, 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 2011 Medicare prescription drug plan options. Vermont seniors and Medicare beneficiaries will see fewer prescription drug plan choices in 2011 and higher premiums. In addition, behind the numbers, some of 2010’s more popular Medicare Part D plans will change their 2011 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. Accordingly, people are reminded to consider their 2011 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 2011. 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 2011. For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information. Questions? Please let us know by clicking here for our Customer Help Desk. Click here to review Medicare Part D plan statistics for the 2011 plan year. |
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