Medicare Open Enrollment Starts
October 15, Here is What We Know So Far
Premiums not expected to rise overall in 2015 - some may
decline - but some plans have signaled significantly higher rates
By Michelle Andrews, Kaiser Health News
1, 2014 - Medicare beneficiaries who want to make changes to their
prescription drug plans or Medicare Advantage coverage can do so
starting Oct. 15 during the Medicare's program’s annual open enrollment
period. There will be somewhat fewer plans to pick from this year, but
in general people will have plenty of options, experts say.
And although premiums aren’t
expected to rise markedly overall in 2015—and in some cases may actually
decline—some individual plans have signaled significantly higher rates.
Rather than rely on the sticker price of a plan alone, it’s critical
that beneficiaries compare the available options in their area to make
sure they’re in the plan that covers the drugs and doctors they need at
the best price.
annual open enrollment period is also a once-a-year opportunity to
switch to a private Medicare Advantage plan from the traditional
Medicare fee-for-service plan or vice versa.
Open enrollment ends Dec. 7.
Although the Centers for Medicare
and Medicaid Services has released some specifics about 2015 premiums
and plans, many details about provider networks, drug formularies and
the like won’t be available until later this fall. Here’s what we know
Standalone Prescription Drug
The number of Part D standalone
prescription drug plans (PDPs) will drop 14 percent, to 1001 plans. This
smallest number of offerings since the Medicare Part D program began
Even so, “seniors across the
country will still have a choice of at least two dozen plans in their
area,” says Tricia Neuman, director of the Program on Medicare Policy at
the Kaiser Family Foundation (KHN is an editorially independent program
of the foundation.)
The drug plan consolidations that
are driving the reductions in choices will likely shift many
beneficiaries into lower cost plans, resulting in an average premium
decline of 2 percent, to $38.95,
according to an analysis by Avalere Health.
But that overall average premium
obscures significant price hikes by some of the biggest plans. The
average premium for the WellCare Classic plan, for example, will
increase 52 percent in 2015, to $31.46, while the Humana Walmart RxPlan
premium will rise 24 percent, to $15.67, according to Avalere.
Insurers are expected to continue
to shift more costs to beneficiaries next year. The percentage of PDP
plans with no deductible will
decline to 42 percent from 47 percent, and,once again, about three
quarters of plans won’t offer any coverage in the “donut hole”— the
coverage gap in which beneficiaries are responsible for shouldering a
greater share of their drug costs.
Underscoring the importance of
evaluating plan options, 70 percent of standalone drug plan members will
likely see their premiums increase if they stick with the same plans in
2015, says Ross Blair, senior vice president for eHealthMedicare.com,
an online vendor.
Seniors, though, have historically
not voluntarily switched plans in great numbers during annual
enrollment. Between 2006 and 2010, on average only 13 percent did so,
according to a 2013 analysis by researchers at Georgetown
University, KFF and the University of Chicago.
Enrollment in Medicare Advantage
plans continues to grow: 30 percent of Medicare beneficiaries are now in
the private plans, which typically are managed care plans that often
provide additional benefits such as vision and dental coverage. Concerns
that Medicare Advantage plans would disappear in large numbers as the
health law gradually reduces their payments to bring them in line with
the traditional Medicare program have proven
unfounded to date. In 2015, the number of plans will drop by 3
percent, to 2,450, continuing a gradual decline.
“You still have lots of plans and
robust selection,” says Caroline Pearson, vice president at Avalere
Health, a research and consulting firm. Some parts of the country appear
to be harder hit by plan reductions than others, including the Southeast
and mid-Atlantic regions, Pearson says.
The average premium will increase
by $2.94 to $33.90, but nearly two-thirds of beneficiaries won’t see any
according to CMS. Like standalone drug plans, however, fewer
Medicare Advantage drug plans will offer no deductibles and gap
coverage, according to Avalere.
“It’s one example of how plans are
tightening up coverage,” and pushing more costs onto consumers, says
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