The Centers for Medicare and Medicaid Services (CMS) recently announced that average monthly Medicare Part D premiums should remain relatively stable in 2017. Based on the Medicare Part D plan carrier bids, the average base monthly premium for 2017 should be around
$34 per month, an
increase of around $1.50 from the
$32.56 actual average premium reported in 2016.
As a reminder: The average monthly Medicare Part D premium figure released by CMS
may not reflect the actual changes in your 2017 Medicare Part D prescription drug plan premiums - or overall coverage. Instead, everyone with a Medicare Part D or Medicare Advantage plan should be prepared to research other, more economic forms of health and prescription coverage during the annual Open Enrollment Period that begins Saturday, October 15, 2016 and continues through Wednesday, December 7th.
As reference, here are the weighted average monthly premiums for a standard or basic Medicare Part D prescription drug plan reported by HHS or CMS since 2007 (with links to past blogs). (We do not have a base premium figure from 2005 reporting on the beginning of the Medicare Part D program in 2006).
Annual estimated basic Medicare Part D premiums 2007 to 2017
Estimated average basic premiums vs. Actual weighted (and unweighted) stand-alone Medicare Part D premiums from 2007 to 2017
Please note: You may notice that the average basic Medicare Part
D premiums reported by CMS are usually lower than the average Medicare
Part D premiums we show in our2017
PDP-Facts area. In
our average premium calculations,
we only consider stand-alone Medicare Part D prescription drug plans
(PDPs). We usually do not group the premiums for Medicare Advantage
plans offering prescription drug coverage (MAPDs) with stand-alone
Medicare Part D plans for several reasons.
First, Medicare Part D plans are offered on a state-wide (or
regional)
basis and Medicare Advantage plans are offered within much smaller
service areas (ZIP Code or county basis), so Medicare Advantage plans
may not be widely available to all Medicare beneficiaries in a state (or
in the case of
Alaska, there are no Medicare Advantage plans available).
Also, we find that the many of MAPDs have a low or $0 premium and these
low premiums tend to skew the average monthly premium for prescription
drug coverage toward lower values that are not reflective of the
stand-alone Medicare Part D plan (PDP) landscape. At any rate, here are
our calculations of average Medicare Part D plan premiums from the past
several years along with a chart showing the variation with CMS
estimated premium figures:
- We calculated the 2016 average monthly premium across
all stand-alone Medicare Part D plans (not considering Medicare
Advantage plans offering prescription drug coverage or MAPDs) to be $53.83 or $39.08
when weighted by stand-alone Medicare Part D plan enrollment
(note: the "enrollment weighting" can change throughout the plan
year as Medicare plans are sanctioned or removed from sanctions).
- We calculated the 2015 average monthly premium across
all stand-alone Medicare Part D plans (not considering Medicare
Advantage plans offering prescription drug coverage or MAPDs) to be $53.14 or $36.75 when weighted by stand-alone Medicare Part D plan enrollment.
- We calculated the 2014 average monthly premium across
all stand-alone Medicare Part D plans (not considering Medicare
Advantage plans offering prescription drug coverage or MAPDs) to be $53.80 or $41.23 when weighted by stand-alone Medicare Part D plan enrollment.
- We calculated the 2013 average monthly premium across all stand-alone Medicare Part D plans to be $53.26 or $40.63 when weighted by all stand-alone Medicare Part D plan enrollment.
- We calculated the 2012 average premium across all stand-alone Medicare Part D plans to be $53.99 or $39.62 when weighted by plan enrollment.
- In 2011, we calculated the average monthly premium across all stand-alone Medicare Part D plans as $53.77 -- or $41.05 when weighted by Medicare Part D plan enrollment.
Common question: Does the CMS average premium increase mean that I will pay only slightly more for my 2017 Medicare Part D plan?
No. The 2017 average premium reported by CMS suggests that you
should be able to shop around and find a 2017 Medicare prescription drug
plan with about the same monthly premium as you currently have now, or
you may want to consider changing enrollment to a Medicare Advantage
plan that includes prescription drug coverage.
Key Point: Even if your Medicare Part D plan premium remains
stable – this does not mean that your 2017 plan’s drug coverage will not
change. Your Medicare drug plan's prescription coverage (which drugs
are covered and at what cost)
can change every year,
even if your monthly Medicare plan premium remains the same. So be
prepared to review your 2017 Medicare plan options starting in early
October 2016.
The full text of the
July 29, 2016 CMS Press Release is included below:
Medicare projects relatively stable average prescription drug premiums in 2017
Today, Medicare announced that the average basic premium for a
Medicare Part D prescription drug plan in 2017 is projected to remain
relatively stable at an estimated $34 per month. This represents an increase of approximately $1.50 over the actual average premium of $32.56 in 2016.
“Stable Medicare prescription drug plan premiums help seniors and
people with disabilities afford their prescription drugs,” said Andy
Slavitt, Acting Administrator of the Centers for Medicare & Medicaid
Services (CMS). “However, I
remain increasingly concerned about the rising cost of drugs, especially
high-cost specialty drugs, and the impact of these costs on the
Medicare program.”
The stability in average
basic Medicare Part D premiums for enrollees comes despite the fact that
Part D costs continue to increase faster than other parts of Medicare,
largely driven by high-cost specialty drugs and their effect on spending
in the catastrophic benefit phase. Although private
prescription drug plans receive capitated payments for portions of the
Part D benefit, Medicare is directly responsible for 80 percent of the
cost of drugs purchased by beneficiaries while in the catastrophic
benefit phase.
As the recent 2016 Medicare Trustees report
noted, growth in the costs of prescription drugs paid by Medicare
continue to exceed growth in other Medicare costs and overall health
expenditures. Medicare Part D
expenditures per enrollee are estimated to increase by an average of 5.8
percent annually through 2025, higher than the combined per-enrollee
growth rate for Medicare Parts A and B (4.0 percent). The report
found that these costs are trending higher than previously predicted,
particularly for specialty drugs. In addition, a March 2016 Department
of Health and Human Services report provided a detailed analysis of high-cost prescription drug spending trends.
Today’s projection for the average premium for 2017 is based on bids
submitted by drug and health plans for basic drug coverage for the 2017
benefit year and calculated by the independent CMS Office of the
Actuary.
Seniors and people with disabilities are continuing to see savings on
out of pocket drug costs as the Affordable Care Act closes the Medicare
Part D “donut hole” over time. Since the enactment of the Affordable
Care Act, more than 10.7 million
seniors and people with disabilities have received discounts of over
$20.8 billion on prescription drugs, an average of $1,945 per
beneficiary.
The upcoming annual Medicare open enrollment period begins on October
15, 2016, and ends on December 7, 2016. During this time, people with
Medicare can choose health and drug plans for 2017 by comparing their
current coverage and plan quality ratings to other plan offerings, or
choose to remain in Original Medicare. CMS anticipates releasing the
premiums and costs for Medicare health and drug plans for the 2017
calendar year in mid-September.
To view the Part D Base Beneficiary Premium, the Part D National
Average Monthly Bid Amount, the Part D Regional Low-Income Premium
Subsidy Amounts, the De Minimis Amount, the Part D Income-Related
Monthly Adjustment Amounts, the 2017 Medicare Advantage Employer Group
Waiver Plan Regional Payment Rates, and the Medicare Advantage Regional
Benchmarks, go to:
www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Ratebooks-and-Supporting-Data.html,
and select “2017.”
To learn more about the Medicare Part D prescription drug benefit, go to: www.medicare.gov/part-d/.
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Emphasis and Highlighting added]
As reference, the text of the
July 29, 2015, CMS Press Release "
Medicare prescription drug premiums projected to remain stable" can be found at:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-07-29.html