Reports & Statistics

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.


The Rising Cost of Living Longer

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A new report on the “Rising Cost of Living Longer” details Medicare spending by age.

A new report on the “Rising Cost of Living Longer” details Medicare spending by age.

A new report from the Kaiser Family Foundation takes a detailed look at per person Medicare spending by age and by service among the nearly 30 million people covered by traditional Medicare in 2011.

This analysis examines the relationship between Medicare per person spending and advancing age, providing new data to inform ongoing federal budget discussions and efforts to improve care for an aging population. Medicare beneficiaries age 80 and older account for a disproportionate share of Medicare spending and are expected to triple as a share of the 65+ population by 2050.

Key findings from the report, The Rising Cost of Living Longer:  Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare, include:

  • Medicare per capita spending for seniors rises with age, as expected, but does not peak until age 96— more than doubling between the ages of 70 and 96, from $7,566 to $16,145 — before declining for the small number of beneficiaries living into their late 90s and beyond.
  • The age at which Medicare per capita spending peaks has increased over time, rising from age 92 in 2000 to age 96 in 2011.
  • The increase in spending by age is not entirely explained by end of life care; in fact, average Medicare spending per person for beneficiaries in traditional Medicare who died during 2011 declined with age, from about $43,000 among 70-year-olds to $20,000 among 100-year-olds.
  • Spending on inpatient hospital care, the largest component of per capita Medicare costs, rises with age and begins to decline only when beneficiaries reach their mid-to-late 90s.  At the same time, skilled nursing facility and hospice per capita spending increases dramatically for beneficiaries in their late 80s and 90s.  These findings raise questions as to whether the very oldest people on Medicare are receiving the appropriate mix of services and in the most appropriate setting.