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Medicare Part D: a first look at prescription drug plans in 2019
Medicare Part D: a first look at prescription drug plans in 2019
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Cubanski, Juliette, author
Damico, Anthony, author
Neuman, Tricia, author - Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- San Francisco, CA : Henry J. Kaiser Family Foundation, October 2018
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Medicare Part D -- economics
Medicare Part D -- statistics & numerical data
United States - Genre(s):
- Technical Report
- Abstract:
- During the Medicare open enrollment period from October 15 to December 7 each year, beneficiaries can enroll in a plan that provides Part D drug coverage, either a stand-alone prescription drug plan (PDP) as a supplement to traditional Medicare, or a Medicare Advantage prescription drug plan (MA-PD), which covers all Medicare benefits, including drugs. This issue brief provides an overview of the 2019 PDP landscape, the largest segment of the Medicare Part D marketplace, with 20.6 million enrollees in 2018. Key Findings. (1) For 2019, Medicare beneficiaries will have more Part D plan choices than in 2018, including 27 standalone PDPs and 21 MA-PDs in their area, on average (excluding MA plans that do not include the drug benefit). A total of 901 PDPs will be offered in the 34 PDP regions in 2019 (plus another 11 PDPs in the territories). This represents an increase of 119 PDPs, or 15 percent, over 2018, and the second year in a row with an increase, after three years of plan reductions. (2) The average monthly PDP premium will increase by a modest 2 percent between 2018 and 2019, to $41.21, weighted by September 2018 enrollment. This estimate, which includes premiums for both basic and enhanced PDPs, is weighted based on current enrollment, assumes current enrollees do not switch, and makes no assumptions about plan choices by new enrollees or reassignment of low-income beneficiaries. (3) For 2019, PDP premiums will vary widely across plans, as in previous years. Among the 10 PDPs with the most enrollees, average premiums will range from a low of $28 per month ($332 per year) for Humana Walmart to a high of $76 per month ($911 per year) for Humana Enhanced (Figure 1). (4) Most Part D enrollees will face modest cost-sharing amounts for generic drugs in 2019 but much higher cost sharing for brands and non-preferred drugs, and a mix of copayments and coinsurance for different formulary tiers. Among the 10 largest PDPs, copayments range from $0 to $5 for preferred generics; $1 to $13 for generics; $25 to $47 for preferred brands; 32% to 50% coinsurance for nonpreferred drugs (the maximum allowed for this tier); and 25% to 33% for specialty drugs. (5) Medicare beneficiaries receiving the Low-Income Subsidy (LIS) will have a choice of six premium-free PDPs in 2019, on average, the same as in 2018. In 2019, nearly one million low-income beneficiaries who are eligible for premium-free Part D coverage will pay Part D premiums averaging nearly $28 per month ($333 per year), unless they switch or are reassigned by CMS to premium-free plans.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (12 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101740375 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101740375