Medicare News

Current news for Medicare beneficiaries and the community that serves them.

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


KFF: Medicare Part D at Ten Years

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In 2015, more than 39 million Medicare beneficiaries are enrolled in Medicare drug plans.

In 2015, more than 39 million Medicare beneficiaries are enrolled in Medicare drug plans.

Since 2006, Medicare beneficiaries have had access through Medicare Part D to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans).

Now in its tenth year, Part D has evolved due to changes in the private plan marketplace and the laws and regulations that govern the program. This report presents findings from an analysis of the Medicare Part D marketplace in 2015 and changes in features of the drug benefit offered by Part D plans since 2006.

In 2015, more than 39 million Medicare beneficiaries are enrolled in Medicare drug plans. Since 2006, the share of Medicare beneficiaries enrolled in a Part D plan has increased from 53 percent to 72 percent of all eligible Medicare beneficiaries.

Go here for key findings.


Hospitals to Team With Home Health for Hip/Knee Replacements

heidi Hospital Discharge, Medicare News Comments Off on Hospitals to Team With Home Health for Hip/Knee Replacements
Patients would benefit from their hospitals and other health care providers, such as home health agencies, working together more closely to coordinate their care. This could lead to better outcomes, a better experience, and fewer complications such as preventable readmissions, infections, or prolonged rehabilitation and recovery.

Patients would benefit from their hospitals and other health care providers, such as home health agencies, working together more closely to coordinate their care. This could lead to better outcomes, a better experience, and fewer complications such as preventable readmissions, infections, or prolonged rehabilitation and recovery.

A proposed new Medicare model would incentivize hospitals to work with home health agencies and other post-acute providers for patients undergoing hip and knee replacements.

All hospitals in 75 geographic areas would be mandated to participate under this five-year bundled payment initiative. They would be held accountable for the costs incurred from the time an orthopedic patient receives surgery to 90 days after discharge, according to the proposed rule released by the Centers for Medicare & Medicaid Services (CMS).

While some incentives exist for hospitals to avoid post-surgery complications that can result in pain, readmissions to the hospital, or protracted rehabilitative care, the quality and cost of care for these hip and knee replacement surgeries still varies greatly. Read more