Medicare Drug Plan Enrollees Would Face Average 13% Premium Increase Unless They Switch Plans During Open Enrollment, New Analysis Finds

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Many Medicare Part D enrollees have access to plans that could lower their premiums or reduce their total drug costs. But, in a typical year, about 9 in ten enrollees stick with the same plan rather than make a switch.

Many Medicare Part D enrollees have access to plans that could lower their premiums or reduce their total drug costs. But, in a typical year, about 9 in ten enrollees stick with the same plan rather than make a switch.

When Medicare’s 2016 open enrollment begins Oct. 15, current enrollees in stand-alone Medicare Part D plans are projected to face an average 13 percent increase in premiums if they remain in their current plan for 2016, a new analysis from Kaiser Family Foundation finds. 

Medicare Part D: A First Look at Plan Offerings in 2016 finds that for the coming year, the average beneficiary will have a choice of 26 stand-alone Part D drug plans, down from 30 last year.  If currently enrolled beneficiaries stay in the same plan next year, average premiums are projected to rise to $41.46 per month, up from $36.68 this year. Many enrollees have access to plans that could lower their premiums or reduce their total drug costs. But, in a typical year, about 9 in ten Part D enrollees stick with the same plan rather than make a switch.

The analysis also identifies other changes for 2016 that could result in enrollees paying more out of pocket to fill their prescriptions.  For instance, more than half (53%) of stand-alone Part D plans will require enrollees to meet the standard Part D deductible, the largest share to impose the maximum allowable deductible since the start of the program. (The standard deductible will be $360 in 2016, up from $320 this year).

As in 2015, most stand-alone plans will charge coinsurance rather than copayments for non-preferred brand name and specialty drugs in 2016, which can result in higher out-of-pocket costs for people who use these drugs, finds the analysis, co-authored by researchers at Georgetown University and the Kaiser Family Foundation.

Medicare’s annual enrollment period runs from Oct. 15 through Dec. 7. During this time, the program’s 55 million beneficiaries are able to choose or change Part D drug plans and Medicare Advantage plans, as well as move between traditional Medicare and a Medicare Advantage plan. Fact sheet explaining the Part D drug benefit is available.

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California

Contact: Craig Palosky | (202) 347-5270 | cpalosky@kff.org