Medicare Open Enrollment Is Fast Approaching — Here’s What We Know So Far
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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鈥檚 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鈥檛 expected to rise markedly overall in 2015鈥攁nd in some cases may actually decline鈥攕ome individual plans have signaled significantly higher rates. Rather than rely on the sticker price of a plan alone, it鈥檚 critical that beneficiaries compare the available聽options聽in their area to make sure they鈥檙e in the plan that covers the drugs and doctors they need at the best price.

The annual open enrollment period聽is聽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. .
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鈥檛 be available until later this fall.聽Here鈥檚 what we know so far:
Standalone Prescription Drug Plans
The number of Part D standalone prescription drug plans聽(PDPs)聽will drop 14 percent, to 1001 plans. This is the since the Medicare Part D program began in 2006.
Even so, 鈥渟eniors across the country will still have a choice of at least two dozen plans in their area,鈥 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聽in choices聽will likely shift many beneficiaries into lower cost plans, resulting in an average premium decline of 2 percent, to $38.95, .
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.
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Insurers are expected to continue to shift more costs to beneficiaries next year. The percentage of聽PDP plans with no deductible聽, and,once again,聽about three quarters of plans won鈥檛 offer any coverage in the 鈥渄onut hole鈥濃 the coverage gap in which聽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聽, an online vendor.
Seniors, though,聽have historically not聽voluntarily聽switched plans in great numbers during annual enrollment. Between 2006 and 2010, on average only 13 percent did so, by researchers at Georgetown University, 麻豆女优 and the University of Chicago.
Medicare Advantage
Enrollment in Medicare Advantage plans continues to grow: 30 percent of Medicare beneficiaries are now in the private plans,聽which聽typically聽are聽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 .聽 In 2015, the number of plans will drop by 3 percent, to 2,450, continuing a gradual decline.
鈥淵ou still have lots of plans and robust selection,鈥 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.
Medicare Advantage coverage has always been concentrated in health maintenance organizations, and this trend will continue in 2015. The number of HMOs will increase by 1.5 percent, to 1,747, while the number of preferred provider organizations will drop by nearly 9 percent, to 541, according to Avalere. .
The average premium will increase by $2.94 to $33.90, but nearly two-thirds of beneficiaries won鈥檛 see any premium increase, .聽 Like standalone drug plans, however, fewer Medicare Advantage drug plans will offer no deductibles and gap coverage, according to Avalere.
鈥淚t鈥檚 one example of how plans are tightening up coverage,鈥 and pushing more costs onto consumers, says Pearson.