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CMS Press release: Medicare Advantage premiums remain stable in 2017; beneficiaries have saved over $23.5 billion on prescription drugs

Category: Annual Medicare plan changes
Published: Sep, 22 2016 03:09:19



The Affordable Care Act has made the Medicare program stronger for seniors and people with disabilities

Today, the Centers for Medicare & Medicaid Services (CMS) announced that 2017 Medicare Advantage premiums will remain stable and more enrollees will have access to higher quality plans while, for the seventh straight year, enrollment is projected to increase to a new all-time high. In addition, CMS released today updated information that shows that millions of seniors and people with disabilities with Medicare continue to enjoy prescription drug discounts and affordable benefits as a result of the Affordable Care Act. Today’s announcement comes as CMS releases the premiums and costs for Medicare health and drug plans for the 2017 calendar year.

CMS estimates that the average Medicare Advantage monthly premium will decrease by $1.19 (about 4 percent) in 2017, from $32.59 on average in 2016 to $31.40. This would be 13 percent lower than the average Medicare Advantage premium prior to passage of the Affordable Care Act. The majority of Medicare Advantage enrollees (67 percent) will experience no premium increase.

“Medicare Advantage and the prescription drug benefit continue to be a great option for seniors and people living with disabilities,” said Andy Slavitt, CMS Acting Administrator. “Medicare enrollees will continue to have access to predictable premiums and high quality care.”

Access to the Medicare Advantage program will remain strong, with 99 percent of Medicare beneficiaries having access to a Medicare health plan. In addition, in 2017, more Medicare Advantage plans will offer more supplemental benefits for enrollees, such as dental, vision, and hearing benefits.

Enrollment is projected to increase to 18.5 million enrollees next year, a 60 percent increase from 2010. In 2017, 32 percent of all Medicare enrollees will be in a Medicare Advantage plan compared to only 24 percent in 2010.

Average premiums in the Medicare Part D prescription drug program will also remain stable and beneficiaries have saved billions on prescription drugs. In July 2016, CMS announced that the average basic premium for a Medicare prescription drug plan in 2017 is projected to be an estimated $34 per month. Today's projections show that access to a prescription drug plan will remain strong in 2017, with 100 percent access to a plan in the individual market and improved access to employer plans.

[Q1Medicare note: our analysis of the 2017 Medicare Part D (PDP) plan data shows a decrease in stand-alone 2017 Medicare Part D plan choices and 67% of 2016 Medicare Part D plan enrollees are estimated to see an increased 2017 Medicare Part D plan premium.]

Because of the Affordable Care Act, people with Medicare are seeing reduced costs through both savings on covered brand-name and generic drugs and access to certain preventive services with no cost sharing. Since the enactment of the Affordable Care Act through July 2016, more than 11 million seniors and people with disabilities have received savings and discounts in the coverage gap of over $23.5 billion on prescription drugs, an average of $2,127 per beneficiary thanks to the law.

Medicare Open Enrollment for 2017 Medicare health and drug plans begins on October 15, 2016 and ends on December 7, 2016. Plan costs and covered benefits can change from year to year. Medicare beneficiaries should look at their coverage choices and decide what options best meet their needs. Beneficiaries can visit Medicare.gov (https://www.medicare.gov), call 1-800-MEDICARE, or contact their State Health Insurance Assistance Program (SHIP). Beneficiaries who are satisfied with their current coverage do not need to do anything.

For more information on the premiums and costs of 2017 Medicare health and drug plans, please visit: https://www.cms.gov/ Medicare/ Prescription-Drug-Coverage/ PrescriptionDrugCovGenIn/ index.html

For a fact sheet on Medicare Advantage and Part D, please visit: https://www.cms.gov/ Newsroom/ MediaReleaseDatabase/ Fact-sheets/ 2016-Fact-sheets-items/ 2016-09-22.html

For more information on Medicare Open Enrollment, including state-by-state fact sheets, please visit: https://www.cms.gov/ Outreach-and-Education/ Reach-Out/ Find-tools-to-help-you-help-others/ Open-Enrollment-Outreach -and-Media-Materials.html

For state-by-state information on discounts in the donut hole, please visit: https://downloads.cms.gov/ files/ Medicare Part D donut hole by state YTD2016 through July 2016.pdf

For state-by-state information on utilization of preventive services at no cost sharing to beneficiaries in Medicare, please visit: https://downloads.cms.gov/ files/ Medicare_Beneficiaries_ Utilizing_Free_ Preventive_Services_ by_State_YTD2016.pdf

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[Emphasis, Additional Links, and Highlighting Added]

Source: https://www.cms.gov /Newsroom/ MediaReleaseDatabase/ Press-releases/ 2016-Press-releases-items/ 2016-09-22.html








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  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
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  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
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  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.