When Mildred Fine received the annual notice informing her about changes to her Medicare prescription drug plan for 2016, she was shocked. If she stayed with the same plan, her monthly premium would more than triple, from $33.90 to $121.10, and her annual deductible would rise from $320 to $360.
The increase didn鈥檛 make sense to Fine, 84, whose prescriptions haven鈥檛 changed聽and whose drugs are generally inexpensive. She takes two generic blood pressure drugs and a generic antidepressant, as well as Estrace, an estrogen cream. This year, she didn鈥檛 meet her deductible until September.
Working with a counselor from her local , Fine logged on to聽 to compare the roughly 20 plans available near her home in Burns, Ore.
She found a plan with no deductible and a monthly premium of $33.50, less than what she pays now.聽Fine estimates she鈥檒l save nearly $1,500 next year in out-of-pocket costs compared with what she would have paid if she鈥檇 stuck with her current plan.
鈥淧eople just have to check their plans every year to see what鈥檚 going on,鈥� Fine says.
But most Medicare beneficiaries don鈥檛 do that, studies show.
罢丑别听 for the private plans offered to Medicare beneficiaries started Oct. 15 and continues until Dec. 7. This is the yearly聽opportunity for聽beneficiaries to switch prescription drug plans or Medicare Advantage managed care medical plans. They can also聽shift between traditional fee-for-service Medicare and Medicare Advantage.
The vast majority of seniors don鈥檛 switch their plans even if by doing so they could get better, cheaper coverage. Nine out of 10 Medicare drug plan enrollees stay in the same plan.
This year, premiums are increasing聽an average 13 percent from $36.68 to $41.46 so checking out the alternatives , according to an analysis by researchers at Georgetown University鈥檚 Health Policy Institute and the . Meanwhile, 53 percent of drug plans will charge the maximum deductible of $360, the largest share to do so since the program began. (KHN is an editorially independent program of the foundation.)
In an , the foundation also reported that聽less than 5 percent of Medicare beneficiaries switched between traditional Medicare and Medicare Advantage on average between 2006 and 2011.
The Kaiser聽foundation conducted last year to ask seniors how they choose and change plans.
鈥淥verall, seniors said they found the process of choosing a plan frustrating, confusing and overwhelming,鈥� says Gretchen Jacobson, associate director at the Program on Medicare Policy at the聽foundation. Having done their homework when they first enrolled, they didn鈥檛 want to do it again.
As one focus group participant cited in the study put it, 鈥淭here are days when I look at a plan, or look at my plan, and I think about possibly making a change, depending upon what鈥檚 out there for me 鈥� I鈥檝e reached the age of 78 and I鈥檓 saying to myself, 鈥業鈥檓 too 鈥β爐ired to investigate this.鈥欌��
This year, it could be especially important to run the numbers, says Jack Hoadley, research professor at Georgetown University鈥檚 Health Policy Institute and a co-author of the drug plan analysis.
鈥淧remiums for the first time in a number of years are moving upward, and while the premium is never the whole story for consumers, it鈥檚 certainly a signal there are potentially higher costs,鈥� Hoadley says.
Monthly premiums for Medicare Advantage managed care plans will remain essentially flat for 2016, dipping 31 cents to $32.60, according to the (CMS).
There will be聽roughly 2,000 plans available, a slight increase, according to the Kaiser Family Foundation. Beneficiaries will have 19 plans to choose from in 2016, on average, compared with 18 this year.
Enrollment in Medicare Advantage plans . Roughly 17 million Medicare beneficiaries are in the managed care plans, representing about a third of all Medicare enrollees.
In 2016, 81聽percent of聽 beneficiaries will have access to a Medicare Advantage plan that does not charge a premium for the聽prescription drug benefit, up from 78 percent this year, according to by the consulting firm Avalere Health. At the same time, out-of-pocket costs may increase for some beneficiaries, as the number of Advantage plans that have no deductible will decline to 55 percent next year from 63 percent in 2015.
Comparing plans to get the best deal isn鈥檛 just good for beneficiaries, it鈥檚 good for the Medicare program as well, says Sean Cavanaugh, deputy CMS administrator and director of the Center for Medicare. Why?聽Plans compete against one another on benefits, premiums and quality. 鈥淚 think the level of quality and service would increase if beneficiaries were willing to move more frequently,鈥� Cavanaugh says.
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