The purpose of this article is to show more detail about the 2016 LIS $0 premium qualifying plan changes: (1) a state perspective (that is in each state, how many Medicare Part D plans qualify for the $0 LIS premium) and (2) a look at the specific Medicare Part D plans qualifying for the $0 LIS premium and the number of states where these plans are offered (or were offered in 2014 and 2015).
First, as noted in the previous article and highlighted below, the vast majority of states are showing fewer 2016 plans qualifying for the LIS $0 premium.
| State LIS Benchmark Premium and Number of Plans Qualifying for the $0 Premium |
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| Region | State(s) | 2016 |
2015 |
2014 |
|||
| Benchmark | Plans | Benchmark | Plans | Benchmark | Plans | ||
| 1 | NH, ME | $32.82 | 9 plans | $29.60 | 9 plans | $27.78 | 7 plans |
| 2 | CT, MA, RI, VT | $31.14 | 6 plans | $29.65 | 5 plans | $27.99 | 8 plans |
| 3 | NY | $39.73 | 7 plans | $36.94 | 8 plans | $37.23 | 8 plans |
| 4 | NJ | $39.98 | 8 plans | $37.64 | 10 plans | $37.10 | 12 plans |
| 5 | DE, DC, MD | $33.45 | 9 plans | $30.61 | 10 plans | $32.34 | 13 plans |
| 6 | PA, WV | $35.30 | 9 plans | $33.91 | 9 plans | $35.50 | 13 plans |
| 7 | VA | $32.78 | 7 plans | $29.47 | 9 plans | $29.34 | 13 plans |
| 8 | NC | $31.07 | 5 plans | $29.34 | 8 plans | $28.28 | 10 plans |
| 9 | SC | $26.57 | 4 plans | $28.78 | 7 plans | $33.87 | 8 plans |
| 10 | GA | $25.78 | 5 plans | $26.47 | 8 plans | $29.32 | 9 plans |
| 11 | FL | $28.07 | 3 plans | $25.83 | 4 plans | $22.13 | 5 plans |
| 12 | AL, TN | $31.32 | 7 plans | $30.20 | 12 plans | $29.67 | 11 plans |
| 13 | MI | $33.47 | 7 plans | $31.46 | 10 plans | $32.46 | 13 plans |
| 14 | OH | $29.52 | 5 plans | $28.64 | 8 plans | $28.93 | 12 plans |
| 15 | IN, KY | $31.90 | 7 plans | $31.79 | 10 plans | $34.95 | 15 plans |
| 16 | WI | $37.70 | 7 plans | $35.32 | 8 plans | $37.03 | 12 plans |
| 17 | IL | $29.60 | 9 plans | $28.23 | 10 plans | $28.59 | 14 plans |
| 18 | MO | $26.13 | 4 plans | $28.28 | 6 plans | $31.21 | 8 plans |
| 19 | AR | $20.92 | 4 plans | $24.76 | 6 plans | $30.03 | 12 plans |
| 20 | MS | $28.14 | 6 plans | $29.33 | 9 plans | $30.56 | 13 plans |
| 21 | LA | $32.13 | 7 plans | $31.28 | 11 plans | $31.75 | 14 plans |
| 22 | TX | $28.05 | 7 plans | $27.31 | 10 plans | $27.73 | 11 plans |
| 23 | OK | $30.72 | 6 plans | $29.97 | 10 plans | $30.18 | 12 plans |
| 24 | KS | $30.67 | 4 plans | $30.32 | 7 plans | $34.21 | 13 plans |
| 25 | IA, MN, MT, ND, NE, SD, WY | $30.93 | 5 plans | $30.00 | 5 plans | $32.23 | 10 plans |
| 26 | NM | $20.72 | 8 plans | $21.19 | 7 plans | $19.92 | 7 plans |
| 27 | CO | $29.89 | 6 plans | $28.93 | 7 plans | $26.90 | 5 plans |
| 28 | AZ | $33.17 | 10 plans | $32.89 | 12 plans | $27.49 | 11 plans |
| 29 | NV | $25.38 | 4 plans | $24.25 | 4 plans | $22.78 | 4 plans |
| 30 | OR, WA | $33.80 | 9 plans | $33.81 | 10 plans | $34.82 | 12 plans |
| 31 | ID, UT | $39.51 | 9 plans | $39.74 | 12 plans | $39.02 | 13 plans |
| 32 | CA | $31.05 | 6 plans | $28.84 | 6 plans | $28.10 | 9 plans |
| 33 | HI | $26.23 | 2 plans | $27.91 | 9 plans | $25.69 | 4 plans |
| 34 | AK | $36.36 | 6 plans | $32.86 | 7 plans | $37.07 | 11 plans |
Next, as can be expected, there are slightly fewer 2016 Medicare Part D plans qualifying for the LIS $0 premium, and their "reach" is to fewer states as compared to 2015 and 2014.
Thirteen (13) LIS qualifying stand-alone Medicare Part D plans will be offered in 2016 as compared to 17 in 2015 and 23 in 2014.
| Low-Income Subsidy Qualifying stand-alone Medicare
Part D Prescription Drug Plans State Count 2016 vs. 2015 and 2014 |
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| 2016 |
2015 |
2014 |
|||
| Plan Name | States Reached | Plan Name | States Reached | Plan Name | States Reached |
| AARP MedicareRx Saver Plus (PDP) | 15 | AARP MedicareRx Saver Plus (PDP) | 33 | AARP MedicareRx Saver Plus (PDP) | 34 |
| Advantage-Plus Meridian (PDP) | 4 | ||||
| Aetna CVS/pharmacy Prescription Drug Plan (PDP) | 19 | ||||
| Aetna Medicare Rx Essentials (PDP) | 4 | ||||
| Aetna Medicare Rx Saver (PDP) | 33 | Aetna Medicare Rx Saver (PDP) | 34 | First Health Part D Essentials (PDP) Crosswalked to Aetna Medicare Rx Saver | 1 |
| Blue Cross MedicareRx Basic (PDP) | 3 | Blue Cross MedicareRx Basic (PDP) | 4 | Blue Cross MedicareRx Basic (PDP) | 4 |
| Blue MedicareRx Standard (PDP) | 6 | ||||
| Blue MedicareRx Value (PDP) | 1 | Blue MedicareRx Value (PDP) | 1 | Blue MedicareRx Value (PDP) | 3 |
| Cigna-HealthSpring Rx Secure (PDP) | 12 | Cigna-HealthSpring Rx Secure (PDP) | 23 | Cigna Medicare Rx Secure (PDP) | 24 |
| Cigna-HealthSpring Rx (PDP) Crosswalked to Cigna-HealthSpring Rx Secure |
19 | ||||
| Colorado Access Vista Medicare PDP (PDP) | 1 | ||||
| EnvisionRxPlus Silver (PDP) | 17 | EnvisionRxPlus Silver (PDP) | 24 | EnvisionRxPlus Silver (PDP) | 19 |
| Express Scripts Medicare - Value (PDP) | 9 | Express Scripts Medicare - Value (PDP) | 8 | Express Scripts Medicare - Value (PDP) | 12 |
| HealthMarkets Value Rx (PDP) | 23 | ||||
| Humana Preferred Rx Plan (PDP) | 33 | Humana Preferred Rx Plan (PDP) | 34 | Humana Preferred Rx Plan (PDP) | 34 |
| Magellan Rx Medicare Basic (PDP) | 11 | ||||
| SecureAdvantage Rx - Option 1 (PDP) | 1 | ||||
| SilverScript Basic (PDP) | 31 | ||||
| SilverScript Choice (PDP) | 32 | SilverScript Choice (PDP) | 32 | ||
| SmartD Rx Saver (PDP) | 27 | SmartD Rx Saver (PDP) sanctioned | 27 | ||
| Symphonix Value Rx (PDP) | 18 | Symphonix Rite Aid Value Rx (PDP) | 18 | Symphonix Rite Aid Value Rx (PDP) | 14 |
| Symphonix Value Rx (PDP) | 11 | Symphonix Value Rx (PDP) | 11 | Symphonix Value Rx (PDP) | 7 |
| Transamerica MedicareRx Classic (PDP) | 4 | Transamerica MedicareRx Classic (PDP) | 1 | ||
| United American - Select (PDP) | 4 | United American - Select (PDP) | 23 | ||
| WellCare Classic (PDP) | 26 | WellCare Classic (PDP) | 21 | WellCare Classic (PDP) | 32 |
| WellCare Simple (PDP) | 5 | WellCare Simple (PDP) | 4 | ||
| Windsor Rx (PDP) | 10 | ||||
| 13 LIS qualifying plans | 17 LIS qualifying plans | 23 LIS qualifying plans | |||
As reference, here is a link to the: 2016 Medicare Part D Low-Income Subsidy Benchmark Premium Amounts (includes 2016 - 2006 for comparison)
Conclusion
Many of the Medicare beneficiaries enrolled in a 2015 Medicare Part D plan that qualifies for the $0 LIS premium will need to move (or be automatically moved) to another 2016 Medicare Part D plan in order to keep a $0 premium. Medicare beneficiaries moved to new plans will need to carefully check their new plan's formulary to ensure coverage of their prescription medications - or seek another plan that provides coverage for their Medicare Part D drugs.
Our recommendation: call a Medicare representative at (1-800-633-4227) and ask for assistance choosing a Medicare Part D or Medicare Advantage plan that most economically covers prescription drugs and healthcare concerns.
You can review national and state level Medicare Part D facts and statistics for the 2016 plan year at PDP-Facts.com/2016. A comparison of Medicare Part D plans per state can be found at PDP-Finder.com/2016 or how the 2016 Medicare Part D plans will change in 2016 at PDP-Compare.com/2016. Both tools can be filtered on LIS qualifying plans. As reference, Medicare Advantage plans information is located at MA-Finder.com/2016 and MA-Compare.com/2016.