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.

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.

A second analysis, What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2016, finds the Medicare Advantage market will change relatively little between 2015 and 2016 in terms of plan offerings. Beneficiaries will have 19 Medicare Advantage plans to choose from in 2016, on average, up slightly from 18 this year.

Nationally, there are a total of 2,001 plans, a slight net increase as 259 new plans enter the market and 203 existing plans exit. These plan departures will affect 3 percent of the nearly 17 million current Medicare Advantage enrollees, a smaller share than were affected last year.

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 sheets explaining the Part D drug benefit and Medicare Advantage are available.