Premiums for the
Top 10 Medicare Prescription Drug Plans to Jump an Average of 10% in
2011
CMS earlier said
average increase will be only $1; Avalere Health analysis finds
significant changes
Sept. 24, 2010 -
The weighted average monthly premiums for the top 10 prescription drug
plans (PDPs) will increase by 10 percent in 2011, according to analysis
by Avalere Health. These plans cover approximately 70 percent of
Medicare participants in a prescription drug plan. The Centers for
Medicare and Medicaid Services announced last month that the average
cost of all PDPs would increase by only $1.
Agency says affordable premiums complement new law’s
increased beneficiary savings on drug costs
Aug. 19, 2010 – The average monthly premium for a
standard Medicare Part D drug plan in 2010 will be about one dollar more
than this year, according the Centers for Medicare & Medicaid Services
(CMS). The agency adds, however, that new discounts for brand-name drugs
through the Affordable Care Act should make medications more affordable
in the future.
Read
more...
“Many
beneficiaries will see relatively dramatic changes in their prescription
drug plans this year,” said Dan Mendelson, CEO of Avalere Health.
“Some major
plans are no longer being offered and premiums for certain plans have
increased significantly. Beneficiaries are going to need to be savvy
consumers and shop around to find the plan that’s best for them.”
(See link to
report from CMS on Aug. 19 saying average PDP cost increase will be $1
in box on left.)
Margaret Nowak,
who worked on the study for Avalere, told the
Associated Press that the jump is due partly to Medicare's
restructuring and partly to the plans offering better coverage in the
doughnut hole, including some brand-name drugs.
The analysis of
the Centers for Medicare and Medicaid Services (CMS) Medicare Part D
landscape file shows that in 2011, United HealthGroup’s AARP’s Medicare
Saver (the 2nd most popular plan) and Universal American’s PrescribaRX
Bronze (the 9th most popular plan) are no longer being offered and
enrollees in those plans will be automatically moved into another Part D
plan offered by the same sponsor, according to the report by Avalere
Health.
This is a result
of CMS’ meaningful differences guidance that requires plans to offer
only one basic and no more than two enhanced plans per region. United
HealthGroup enrollees will be moved into the AARP Medicare Rx Preferred
plan and Universal American enrollees will be moved into the Community
CCRx Basic plan.
The companies can
begin marketing their plans on Oct. 1 and seniors – facing some big
changes in key plans – can choose to change plans during the Medicare
Open Enrollment period that begins November 15 and ends on the last day
of the year.
2010 Top 10
Stand-Alone PDPs
Plan
Name
Enrollment
as of 7/2010
AARP
MedicareRx Preferred (PDP)
2,787,108
AARP
MedicareRx Saver (PDP)*
1,539,917
Humana
Enhanced
1,277,013
Community CCRx Basic (PDP)
1,227,337
First
Health Part D-Premier (PDP)
580,492
SilverScript Value (PDP)
575,544
WellCare
Classic (PDP)
499,170
PrescribaRx Bronze*
482,209
AdvantraRx Value (PDP)
448,386
Advantage Star Plan by RxAmerica (PDP)
443,202
*The
plan sponsors are no longer offering these specific plans in
2011.
Based on Avalere assumptions, the
enrollment weighted-average monthly premiums for the top 10 stand-alone
PDPs increased by 10 percent in 2011, with the largest increase in
the First Health Part D Premier Plus, an enhanced Part D plan.
Three of the top
10 stand-alone PDPs decreased their premiums between 2 percent and 11
percent, including the AARP Medicare Rx Preferred plan, which is
the plan with the highest enrollment.
2011 Top 10 Stand-Alone PDPs with
Enrollment-Weighted Average Monthly Beneficiary Premiums
Top 10
PDP
Enrollment
as of 7/2010
2010
2011
% Change
AARP MedicareRx Preferred (PDP)**
4,374,354
$39.40
$34.97
-11.24%
Community CCRx Basic (PDP)**
1,707,642
$28.85
$29.70
2.95%
Humana Enhanced (PDP)
1,027,062
$41.40
$44.64
7.83%
First Health Part D Premier
Plus (PDP)
888,953
$63.54
$90.78
42.87%
First Health Part D Premier (PDP)
729,424
$30.69
$37.15
21.05%
CVS Caremark Value (PDP)
575,484
$33.70
$33.03
-1.99%
CIGNA Medicare Rx Plan One (PDP)
514,136
$29.14
$34.87
19.66%
WellCare Classic (PDP)
499,170
$28.07
$31.71
12.97%
Advantage Star Plan by
RxAmerica (PDP)
443,202
$29.57
$29.00
-1.93%
Health Net Orange Option 1 (PDP)
376,031
$28.79
$30.53
6.04%
Top 3
7,109,058
$37.47
$35.10
-6.33%
Top 10
7,109,058
$35.44
$39.02
10.10%
**Enrollment
figures for the AARP Medicare Rx Preferred plan include
enrollment from the non-renewed 2010 AARP Medicare Rx Saver
plan. Enrollment figures for the Community CCRx Basic plan
include enrollment from the non-renewed 2010 PrescribaRx Bronze
plan.
Moreover, as shown in the table
below, two of the top 10 stand-alone PDPs in 2011 are enhanced plans and
offer some coverage of drugs in the coverage gap.
Gap Coverage Offered and Other Features of the 2011 Top 10
Stand-Alone PDPs
**
Enrollment figures for the AARP Medicare Rx Preferred plan include
enrollment from the non-renewed 2010 AARP Medicare Rx Saver plan.
Enrollment figures for the Community CCRx Basic plan include enrollment
from the non-renewed 2010 PrescribaRx Bronze plan. *** Deductible for Humana
Enhanced reflects median deductible. Actual deductibles range from $0 to
$150.
The analysis is
conducted using the CMS landscape file and Avalere Health’s DataFrame, a
proprietary database of all stand-alone prescription drug plans and
Medicare Advantage prescription drug plans, according to Avalere Health.
Avalere Health
says it is an advisory services company whose core purpose is to create
innovative solutions to complex healthcare problems. Based in Washington
DC, the firm delivers research, analysis, insight, and strategy for
leaders in healthcare business and policy. Avalere's experts span 125
staff drawn from the federal government (e.g., CMS, OMB, CBO, and the
Congress), Fortune 500 healthcare companies, top consultancies, and
nonprofits. The firm offers deep substance in areas ranging from
healthcare coverage and financing to the changing role of evidence in
healthcare decision-making. Its focus on strategy is supported by a
rigorous, in-house analytic research group that uses public and private
data to generate quantitative insight. Through events, publications, and
interactive programs, Avalere also translates real-time healthcare
developments into actionable information.
Sept. 24, 2010 -
The weighted average monthly premiums for the top 10 prescription drug
plans (PDPs) will increase by 10 percent in 2011, according to analysis
by Avalere Health. These plans cover approximately 70 percent of
Medicare participants in a prescription drug plan. The Centers for
Medicare and Medicaid Services announced last month that the average
cost of all PDPs would increase by only $1.