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Medicare Part D: A First Look at Prescription Drug Plans in 2017

Introduction
  1. These enrollment counts include nearly 7 million Part D enrollees in employer-only plans, not otherwise included in this analysis.

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  2. For analysis of the 2016 Part D marketplace, see Jack Hoadley, Juliette Cubanski, and Tricia Neuman, “Medicare Part D in 2016 and Trends over Time,” Kaiser Family Foundation, September 2016, available at http://kff.org/medicare/report/medicare-part-d-in-2016-and-trends-over-time/.

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  3. Centers for Medicare & Medicaid Services (CMS), “Medicare Advantage Premiums Remain Stable; Enrollment at All-Time High,” September 22, 2016; 2017 PDP, MA, and SNP Landscape Source Files and related files are available at http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/.

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Findings
  1. The average is weighted by enrollment.

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  2. In addition, the PDPs offered by WellCare changed contract numbers.

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  3. Based on authors' analysis using the CMS 2017 Part D Crosswalk file.

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  4. CMS, “Medicare Projects Relatively Stable Average Prescription Drug Premiums in 2017,” available at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-07-29.html.

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  5. During 2016, the average premium continued to drop, most likely due to plan elections by newly eligible beneficiaries, who are likely to enroll in plans with below-average premiums. The average PDP premium fell from $39.21 in February to $38.97 in April to $38.57 in September, a net drop of 1.6 percent in seven months.

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  6. The weighted average premium is projected to increase by 9 percent from $29.08 in 2016 to $31.81 in 2017 for basic-benefit PDPs and by 10 percent from $52.01 to $57.13 for enhanced-benefit PDPs.

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  7. Jack Hoadley, Juliette Cubanski, and Tricia Neuman, "Medicare Part D in 2016 and Trends over Time.”

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  8. Beginning in the 2017 plan year, CMS has suggested that Part D plans change the designation of the tier formerly labeled as non-preferred brand drugs to non-preferred drugs. This reflects the fact that some drugs in this tier are generics. Some plans label their tier for non-preferred generic drugs as simply generic drugs.

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  9. We use weighted median amounts to characterize typical cost sharing.

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  10. Because there are small differences in cost sharing for the same PDP across regions, PDPs in the Delaware/Maryland/DC region are used for these examples.

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  11. Plans qualifying through the de minimis policy are eligible for new enrollees, but will not receive auto-assigned enrollees.

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  12. These counts of benchmark plans include those designated as de minimis plans, which will not receive auto-assigned enrollees.

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  13. Estimates for the total number of beneficiaries who are subject to paying a premium are based on plan data from the landscape and crosswalk files, together with CMS enrollment reports. Data from these files do not allow us to estimate how many will be reassigned.

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  14. Jack Hoadley, Juliette Cubanski, and Tricia Neuman, “It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016,” Kaiser Family Foundation, December 2015, available at http://kff.org/medicare/issue-brief/it-pays-to-shop-variation-in-out-of-pocket-costs-for-medicare-part-d-enrollees-in-2016/.

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  15. 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, available at http://kff.org/medicare/issue-brief/to-switch-or-not-to-switch-are-medicare-beneficiaries-switching-drug-plans-to-save-money/.

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  16. Jack Hoadley, Laura Summer, Elizabeth Hargrave, Samuel Stromberg, Juliette Cubanski, and Tricia Neuman, “To Switch or Be Switched: Examining Changes in Drug Plan Enrollment among Medicare Part D Low-Income Subsidy Beneficiaries,” Kaiser Family Foundation, July 2015, available at http://kff.org/medicare/report/to-switch-or-be-switched-examining-changes-in-drug-plan-enrollment-among-medicare-part-d-low-income-subsidy-enrollees/.

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