Medicare Part D Drug Plan Premiums Rise
- By BSTQ Staff
Monthly premiums for Medicare beneficiaries who are enrolled in Part D stand-alone prescription drug plans will rise 11 percent on average to $38.85 in 2010 if beneficiaries stay in their current plans, according to a new Kaiser Family Foundation analysis. Average monthly premiums have gone up by 50 percent for stand-alone Part D prescription drug plans since the launch of Medicare’s drug benefit in 2006, when monthly premiums averaged $25.93.
As many as 1.2 million people on Medicare will see monthly premiums increase by at least $10 unless they switch to a less-expensive plan. Many of these individuals will also receive lower Social Security checks because their Part D premiums are deducted directly from their payments, and there will be no cost-ofliving increase for Social Security in 2010. In addition, for the first time since the Medicare drug benefit launched, a majority of stand-alone drug plans (61 percent) will require enrollees to meet a deductible before coverage begins, up from 45 percent last year and 42 percent in 2006.
The vast majority (80 percent) of all stand-alone Part D plans will have a gap in coverage, known as the “doughnut hole,” up from 75 percent last year.When enrollees reach the gap, they will have to pay the full price of their medications. And, coverage will be limited to generic drugs for the 20 percent of stand-alone plans with some coverage in the gap. Although members of Congress proposed different options to remove the doughnut hole and decrease premiums, none of the health insurance reform proposals do either. However, options do exist to decrease the coverage gap (doughnut hole).
Changes in Medicare Part D and other healthcare plans also shift some coverages to Tier IV andV drug benefit plans. These coverages include plasma therapies, biologics and other expensive therapies that will no longer be covered under major medical or Tier I, II and III drug plans in which patients are responsible to pay a standard copay. Instead, patients now may be forced to pay coinsurance, which is 10 percent to 30 percent of the cost of the drug.