With the release of the 2014 plans for this enrollment period, it is important to understand any changes that have occurred. There have been changes is the out-of-pocket costs of the insurance formularies, the number of plans that are available, etc. Here is a list of some of the changes to Part D plans.
Fewer Medicare Part D Plans (PDPs)
In 2013, the average number of PDPs/state was 31. For 2014, the average is 29. However, this is also due to the fact that SmartD and SiverScript have been sanctioned by CMS, so they are not included in the 2014 plans. When comparing plans, it is aso to note that not that many plans are unavailable anymore, but rather they have changed their name. So when you are comparing plans, make sure that your plan is still available by looking up the plan id to ensure you are comparing the right one/if the plan doesn’t exist and you are not covered at all, as the id will remain the same.
Increase in the Monthly Premiums
As seen in last week’s blog on if you are in the right PDP, your premiums might increase this year. However, this will occur if you stay in your current 2013 plan. In other words, around 73% of people enrolled in a PDP will see an average increase in premiums of $6 per month. So make sure that you check to see that you are in the most affordable plan! Overall, there is only an average increase in plan premiums from $53.26 to $53.35, so the plans, overall, have not changed drastically.
More Inexpensive Plan Options
While your premiums could increase, there will be more plans available that offer monthly premiums under $25/month or $300/year. The premiums depend on which state you are in where the lowest premium is around $12.60.
Changes in Donut Hole Coverage
There will be fewer PDPs, only 21%, that offer some partial Donut Hole coverage, as there were in 2013, where some plans even offered complete generic coverage when in the Hole. However, as part of the Affordable Care Act which will decrease the Donut Hole, the Donut Hole will begin to shrink this year, where Medicare recipients will pay 72% of the cost of a covered generic drug (a decrease from 79% in 2013) and the plan will pay the rest. However, the amount that a recipient will pay in 2014 for brand name drugs will remain the same at 47.5%. Overall, theDonut Hole now begins when your drug costs exceed $2,850, a decrease from $2,970 in 2013. Here are tables that show the changes in the cost recipients will see as the Donut Hole shrinks.
Changes in Initial Deductibles
45% of all 2014 PDPs will offer a $0 initial deductible, so the majority of plans will have some type of initial deductible, where the standard model PDP has a $310 initial deductible, a decrease from the 2013 standard of $325.
Changes in Low-Income Subsidy Benchmarks
Similar to how plan premiums change every year, so do the Low-Income Subsidy (LIS) benchmarks. Some LIS Medicare recipients are automatically enrolled/changed into a plan that offers a $0 monthly premium. However, if you do not receive this service, you could be placed into a plan that does not have a $0 monthly premium, so it is very important to find a plan that offers a $0 monthly premium. Similarly, if you do not receive full premium coverage, you still need to compare the plans available to you so that you are in the one that covers the most of your premium and reduces your out-of-pocket costs the most.