Q1Group 2016 PDP Analysis Summary: Many Medicare beneficiaries will see higher plan premiums and find fewer plan choices.

A 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, Illinois, and Florida 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.
As 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.
Most 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 “this site analysis of the 2014 to 2016 decline of Medicare Part D plans qualifying for the $0 premium Low-Income Subsidy (LIS)”.
The 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.
The 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.
Most 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.
All 2016 Medicare Part D plans will have the standard 2016 Initial Coverage Limit of $3,310. However, some Medicare 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.
Fewer 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: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY National Statistics.

Please note: The above information is from our Medicare Part D plan landscape summaries and 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 15^th and continues through Monday, December 7^th, 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 Medicare representative.