preliminary analysis of the 2016 stand-alone Medicare Part D prescription drug
plan (PDP) landscape data recently released by the Centers for Medicare and
Medicaid Services (CMS) shows that, in general, Medicare beneficiaries will
have fewer 2016 Medicare Part D plan choices in most states and may pay higher
monthly PDP premiums. More specifically:
- As was true last year, there will be
fewer 2016 stand-alone Medicare Part D prescription drug plan (PDP)
choices. The average number of stand-alone 2016 Medicare Part D plans
offered in each state dropped to 26 stand-alone PDPs from an average of 29 stand-alone
Part D plans available in 2015. Alaska,
saw the largest decrease of stand-alone Medicare Part D plans in
2016. You can click
here to read more about plan availability and see a chart of
how the average number of Medicare Part D plans has changed since 2007.
in past years, some Medicare Part D plans in your area may be changing
their names or are discontinued in 2016. You can see more 2016
Medicare Part D plan changes using our PDP-Compare tool found here: PDP-Compare.com/2016.
states will have fewer Medicare Part D plans qualifying for the state’s
Low-Income Subsidy (LIS) $0 premium. The state offering the smallest
selection of $0 premium LIS plans is: Hawaii, with two (2) 2016 $0-premium LIS plans (down
from nine (9) qualifying 2015 Part D plans). You can click
here to read more about $0 premium LIS plan availability and see a
chart of how the average number of $0 LIS qualifying Medicare Part D plans
has changed since 2007. For more about the decline in the number of
LIS $0 premium plans, you can click
here for our article “Q1Group analysis of the 2014 to 2016 decline of
Medicare Part D plans qualifying for the $0 premium Low-Income Subsidy
national average 2016 stand-alone Medicare Part D premium will increase by
only 1%. However, when premiums are weighted by plan enrollment, the
average weighted Medicare Part D plan premium will increase 13% to
$41.34. Based on premium increases and plan enrollment, around 77%
of all Medicare beneficiaries currently enrolled in a stand-alone 2015
Medicare Part D plan (PDP) will see an increase in their 2016 monthly
premium, unless they change coverage to a more affordable 2016 Medicare
Part D or Medicare Advantage plan that includes prescription drug
coverage. The average
2016 PDP premium increase is $7.40. You can click
here to read more about how the average and average-weighted Medicare
Part D plan premiums have changed since 2007.
lowest-costing 2016 Medicare Part D plan will be the SilverScript Choice (PDP) offered in Arkansas
($11.40). In many other states, the Humana Walmart Rx plan will continue to have the
lowest monthly premium ($18.40). Overall, fewer 2016 Medicare Part D
plans will be available with monthly premiums under $25. The 2016
Medicare Part D plan with the most expensive premium will be the
Florida BlueMedicare Rx-Option 2 (PDP) ($174.70). You can click
here to read more about the Medicare Part D plans with the lowest and
highest premiums and how the range of premiums has changed since 2007.
2016 Medicare Part D plans will have an Initial Deductible that can range
from $200 to the 2016 standard Initial Deductible of $360. As an
example, of the 27 plans available in Ohio, only 9 stand-alone Medicare Part D plans will have a $0
initial deductible in 2016. Click
here to see a graph of the changes in the total number of Medicare
Part D plans offering a $0 deductible.
2016 Medicare Part D plans will have the standard 2016 Initial Coverage Limit of $3,310. However,
Advantage plans that offer prescription drug coverage may offer a
higher Initial Coverage Limit, meaning plan Members will be able to buy
more formulary medications before reaching the 2016 Donut Hole.
2016 Medicare Part D plans will offer any Donut Hole coverage for
purchases made while in the Coverage Gap. However, the good news is
that the 2016 Donut Hole discount will remain at 55% for
brand-name drugs and increase to a 42% discount for generic
medications. You can click
here to read more on the 2016 Donut Hole.
If you would like to see a specific state’s PDP landscape
summary, please use the following links to our interactive 2016 PDP-Facts:
Please note: The above information is from our Medicare Part
D plan landscape summaries
based on stand-alone Medicare Part D prescription drug plans (or PDPs).
The 2016 Medicare Advantage plan landscape summary will be presented in our
next Newsletter. A number of the 2016
Medicare Advantage plans
may be available in your area and may include
comprehensive prescription drug coverage, along with Medicare Part A
(hospitalization), Medicare Part B (out-patient and physician), and additional
healthcare benefits (these Medicare plans are also called MAPD plans).
Reminder: No need to rush.
The annual Medicare Open Enrollment Period for 2016 Medicare Part D plans and
Medicare Advantage plans begins on Thursday, October 15th
continues through Monday, December 7th
, with 2016 Medicare plan
coverage beginning on Friday, January 1, 2016. For more information,
Medicare beneficiaries can telephone Medicare at 1-800-633-4227 to speak with a