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  • West Virginia’s 2016 Medicare Part D plan overview

    Introduction:
    Based on the 2016 Medicare Part D prescription drug plan information released by the Centers for Medicare and Medicaid Services (CMS), West Virginia seniors and Medicare beneficiaries will find that 2016 will bring a number of changes to their prescription drug coverage and beneficiaries should be prepared to see how their current 2015 Medicare Part D plan is changing in 2016. To assist, we now have our 2016 PDP-Compare ANOC tool online to show basic changes in plan coverage at PDP-Compare.com/2016/WV.

    Please note that the information we provide below is based only on stand-alone Medicare Part D prescription drug plans (PDPs).  We do not compare stand-alone drug plans directly with Medicare Advantage plans because Medicare Advantage plans provide coverage for Medicare Part A (in-patient hospital coverage), Medicare B (out-patient physician visits), and may include comprehensive prescription drug coverage (called MAPD plans).  Medicare Advantage plans may also include additional benefits such as dental, vision, and health club coverage.  For more information, seniors can review all Medicare Advantage plans available in their area using our 2016 MA-Finder.

    What’s new for West Virginia’s
    2016 Medicare Part D Prescription Drug Plans

    West Virginia 2016 Medicare Part D premium increases and decreases:
    Of the 29 Medicare Part D plans available in West Virginia for 2016, 5 plans will lower their premiums and 18 will increase their premiums. Currently, 62.3% of West Virginia residents enrolled in a stand-alone Medicare Part D plan are enrolled in one of the 18 plans with a premium increase. The average premium increase for members of these plans will be $6.80.

    The 2016 average monthly Medicare Part D premium in West Virginia will increase:
    Overall, the average monthly 2016 prescription drug plan premiums in West Virginia will increase 0.24% from a 2015 average monthly premium of $58.94 to a 2016 average Part D plan premium of $59.18.

    The average monthly premium discussed above consider all Medicare Part D plans equally.  Perhaps a more telling average is the weighted average — that is, looking at each plan’s monthly premium weighted by the number of people enrolled in that particular plan.  Based on the weighted average, West Virginia residents can expect to see a 5% increase in their monthly premiums. This means that if everyone stays in their current 2015 prescription drug plan through 2016, then across the state we can expect beneficiaries to pay 5% more for their monthly premium.

    As reference, the national average monthly Medicare Part D premium will increase from $53.14 in 2015 to $53.83 in 2016.  Based on the 2015 enrollment figures, 77.7% of Medicare Part D beneficiaries nationwide (over 15 million people) could experience an average increase in premium of $7.4, unless they switch to a lower priced plan.   

    West Virginia will have the same number of Medicare Part D (PDP) plan choices:
    A wide assortment of national and regional Medicare Part D plans are offered in each state or CMS region, with the average number of prescription drug plans offered per state decreasing from 29 plans in 2015 to 26 plans in 2016. You can review all 2016 Medicare Part D Plans available in West Virginia at PDP-Finder.com/2016/WV.

    Locally, West Virginia residents will find that the total number of stand-alone 2016 Medicare prescription drug plans has not changed and remains at 29 available Part D plans.

    As a note, if you find that your current 2015 Part D plan is not being offered in 2016, 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 2016 prescription drug plan or whether you will need to actively choose a new 2016 Medicare Part D plan.

    If you are automatically switched to a new plan for any reason, please review the new plan closely.  Automatic plan switches DO NOT take into account your specific medication coverage and pharmacy needs. Check to be sure that your new plan covers your needs.

    The range of monthly drug plan premiums will decrease:
    The premiums within West Virginia will range from $18.40 (Humana Walmart Rx Plan (PDP) in PA WV) to $149.60 (Blue Rx PDP Complete (PDP) in PA WV) — as compared to the 2015 West Virginia monthly premium range of $15.70 to $151.80.

    In comparison, across the country the 2016 Medicare Part D plan premiums range from a low of $11.40 (SilverScript Choice (PDP) in AR) to a high of $174.70 (BlueMedicare Rx-Option 2 (PDP) in FL).

    The same number of Medicare Part D plans with a monthly premium under $25:
    When reviewing lower premium Medicare Part D (PDP) plans, West Virginia residents will have the same number of plan options. There will be 2 plans having a premium under $25, remaining unchanged from the 2 Part D plans offered in 2015.

    Fewer Medicare prescription drug plans will offer some level of Coverage Gap protection:
    The selection of prescription drug plans with donut hole coverage has also changed with fewer companies offering 2016 Part D plans with some level of additional coverage (over the standard generic and brand-name drug discounts) for purchases made in the coverage gap.   In 2015, 7 plans offered plans with some form of donut hole coverage and in 2016 that number will decrease to 6 plans.  People are reminded to see which drugs are actually covered in the donut hole because some Medicare Part D plans only cover a "few" drugs through the coverage gap.

    Remember, even if your Medicare Part D plan has "No Gap Coverage", you still get the standard 2016 generic drug discount of 42% and brand-name drug discount of 55%.   You can read more here.

    Fewer Medicare prescription drug plans are offered with enhanced options:
    West Virginia residents will find that fewer Part D plans will offer enhanced prescription drug coverage options with 15 enhanced Part D plans in 2016 as compared to 16 in 2015.  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 2016, fewer West Virginia Part D plans will offer prescription drug coverage with a $0 initial deductible (11 plans in 2016 as compared to 13 plans in 2015).

    Low-Income Subsidy recipients in West Virginia will have the same number of Medicare Part D plans that qualify for the $0 monthly premium:
    West Virginia Medicare beneficiaries who qualify for full "Extra Help" will find no change in the number of Part D plans qualify for the $0 premium Low-Income Subsidy as compared to last year.  In 2015, 9 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy and this number (9 Part D plans) does not change for 2016.

    Please note, if you received "Extra Help" in 2015 and your plan does not qualify for the $0 premium in 2016, 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 your prescriptions are not covered, you can switch to a plan that will cover your medications.

    To Summarize:
    West Virginia seniors and Medicare beneficiaries will see the same number of prescription drug plan choices in 2016 and can expect to see higher monthly premiums.

    In addition, behind the numbers, some of 2015’s more popular Medicare Part D plans will change their 2016 plan structure.  Some plans are adding initial deductibles or changing cost-sharing limits (for instance, how much you pay for a covered drug).

    Also, all 2016 plans changed their initial coverage limit — defining when you enter the Coverage Gap.

    Accordingly, beneficiaries are reminded to consider their 2016 prescription drug plan options carefully.  If you are a Medicare beneficiary and make no decision about changing 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 your plan’s coverage or cost for 2016.  If your prescription drug plan will be discontinued, and you are not automatically moved into a new plan, you will need to enroll in another Part D plan or you may not have prescription drug coverage in 2016.

    What is the Bottom Line?
                    Review your 2016 Medicare prescription drug plan options.

    Important Dates:

    Medicare Part D Plan Marketing begins: October 1, 2015
    Annual Open Enrollment Period: October 15, 2015 through December 7, 2015
    New Coverage begins: January 1, 2016

    For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information. You can review the 2016 West Virginia Medicare Part D Facts page at PDP-Facts.com/2016/WV

    Questions? Please let us know by clicking here for our Customer Help Desk.

    Click here to review Medicare Part D plan statistics for the 2016 plan year.

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