Medicare Part D: A First Look at Plan Offerings in 2014
Centers for Medicare and Medicaid Services, “More, higher quality options for seniors in Medicare Advantage,” September 19, 2013; 2014 PDP, MA, and SNP Landscape Source Files and related files are available at http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/.
These enrollment counts (September 2013) include 6.1 million Part D enrollees in employer-only plans, not otherwise analyzed for this spotlight.
Other Medicare Part D Data Spotlights from 2008 to 2013, based on the authors’ analysis of CMS data, are available at http://www.kff.org/medicare/resources-on-the-medicare-prescription-drug-benefit-2/.
It is unknown at present whether the renamed Humana Preferred Rx Plan will have a broader preferred network beyond Walmart pharmacies.
Based on authors' analysis using the CMS 2014 Part D Crosswalk file.
This calculation includes LIS enrollees, who are not necessarily responsible for paying the increased premium (see the LIS section for more information). The share of non-LIS PDP enrollees projected to have a premium increase of at least $1 is even larger—78 percent of all enrollees. Nearly one in five non-LIS enrollees have a projected premium increase of at least $10 per month.
Centers for Medicare & Medicaid Services, “Annual Release of Part D National Average Bid Amount and other Part C & D Bid Related Information,” July 30, 2013.
Kaiser Family Foundation, “Income-Relating Medicare Part B and Part D Premiums Under Current Law and Recent Proposals: What are the Implications for Beneficiaries?” February 2012, available at http://www.kff.org/medicare/8276.cfm.
This amount corresponds to the estimated catastrophic coverage limit for non-Low-Income Subsidy enrollees ($6,455 for LIS enrollees), which corresponds to True Out-of-Pocket (TrOOP) spending of $4,550 (the amount used to determine when an enrollee reaches the catastrophic coverage threshold.
Information is not available for the gap coverage of one PDP, SmartD Rx Plus, offered in all 34 regions. This plan is included in the denominator but not in any of the coverage categories.
Centers for Medicare & Medicaid Services, “Announcement of Calendar Year (CY) 2014 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter,” April 1, 2013.
Plans qualifying through the de minimis policy are eligible for new enrollees, but will not receive auto-assigned enrollees.
Estimates for the total number of beneficiaries subject to paying a premium are based on plan data from the landscape and crosswalk files, together with CMS enrollment reports. Estimates of the number scheduled to be reassigned are not available from CMS, as of the publication date.
Jack Hoadley, Elizabeth Hargrave, Laura Summer, Juliette Cubanski, and Tricia Neuman, "To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Money?" Kaiser Family Foundation, October 2013.