This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2014, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans and describes the changes in limits on out-of-pocket expenses and prescription drug coverage in the Part D “donut hole” provided by the plans in 2014.
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This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government’s online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor’s offices and pharmacists. After they enroll in a plan, many seniors did not revisit their initial decision or review plan options without the strong provocation of a substantial increase in cost, change in coverage, or shift in personal health care needs. Moreover, they feared that a change in plans may disrupt their care, or lead to an unforeseen increase in out-of-pocket costs, and require them to learn new rules and requirements. They are doubtful they would end up in a plan that is appreciatively different or better for them. Overall, seniors preferred to have numerous choices in plans but would like personalized help and advice from experts to ease the process.
This Data Spotlight reviews national and state-level enrollment trends as of March 2015 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.
Medicare Advantage Enrollment Continues to Climb, but Financial Protections for Enrollees Are Eroding
Enrollment in Medicare Advantage continues to climb steadily as spending reductions enacted in the Affordable Care Act reduce historical overpayments to the private plans, according to a new analysis by the Kaiser Family Foundation. But limits on out-of-pocket spending for Medicare-covered services are rising, providing less protection for enrollees with…
To Switch or Be Switched: Examining Changes in Drug Plan Enrollment among Medicare Part D Low-Income Subsidy Enrollees
During the Medicare Part D annual enrollment period, people on Medicare can review and compare stand-alone prescription drug plans (PDPs) and Medicare Advantage plans and switch plans if they choose. Low-income beneficiaries who receive premium and cost-sharing assistance through the Part D Low-Income Subsidy (LIS) program have a subset of premium-free PDPs (benchmark plans) available to them, but can also choose to enroll in a non-benchmark plan and pay a premium. This analysis examines plan changes among LIS enrollees in PDPs between 2006 and 2010.
Medicare Drug Plan Enrollees Would Face Average 13 Percent Premium Increase Unless They Switch Plans During Open Enrollment, New Analysis Finds
Second Analysis Finds Modest Shifts in Medicare Advantage Plan Options 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 finds.…
This issue brief provides an overview of the Medicare Part D stand-alone prescription drug plan options available in 2015 and key changes from prior years. The analysis examines Part D plan availability, premiums, benefit design features, and low income subsidy plan availability.
A new comprehensive Kaiser Family Foundation report analyzes key trends that have shaped the Medicare Part D marketplace since the program launched nine years ago, providing a detailed assessment of changes in plan availability, enrollment, premiums and cost sharing in both private stand-alone drug plans, and Medicare Advantage drug plans.
Health Affairs Article: Medicare’s Part D Drug Benefit At 10 Years: Firmly Established But Still Evolving
Despite initial controversy and uncertainties, Medicare Part D now provides drug coverage to thirty-nine million beneficiaries through dozens of private plans in each region. Although firmly established, the program faces challenges, including projected spending growth. Enrollees also face challenges as plans adopt new strategies to control costs.