Driven by a consolidation of offerings, the number of Part D prescription drug plans will decrease by 14% in 2015. While monthly premiums will decrease overall by 2%, there will be large premium variations.
Driven by a consolidation of offerings, the number of Part D prescription drug plans will decrease by 14% in 2015, according to Avalere Health’s analysis of CMS’ filings for 2015.
Plan sponsors will rely on more highly managed plan products. The number of health maintenance organization plans will increase 1.5%, while the number of preferred provider organizations will decrease by nearly 9% from 2014 to 2015.
Top plan sponsors like Aetna, Cigna, CVS, and UnitedHealth are driving the prescription drug plan reduction by consolidating their offerings. As a result, the average monthly premiums for these drug plans will decrease by 2% from $39.88 in 2014 to $38.95 as a large number of beneficiaries are shifted into lower-cost plans, according to Avalere’s calculations.
Avalere warns about large premium variations. Aetna’s new Medicare Rx Saver plan reduces premiums by more than 30%, but WellCare’s Classic plan is increasing premiums by more than 50%. However, overall, half of the top 10 prescription drug plans will have average premiums lower than $30.
“When seniors choose a prescription drug plan for 2015, they should carefully look at their options to select the plan that best meets their health and financial needs,” Christine Harhaj, senior manager at Avalere Health, said in a statement. “While beneficiaries will welcome lower premiums, they will need to look at other facets of benefit design including how their medications are covered, cost sharing responsibilities, and total out-of-pocket spending.”
In 2015, 42% of drug plans will have $0 deductibles, a decline from 47% in 2014. Additionally, roughly three-quarters of plans will not cover drugs in the Part D coverage gap next year.
The number of plans participating in Medicare Advantage will also decline 3% to 2,450 in 2015 from 2,527 in 2014. The regions that will see the most sizeable plan withdrawals are high-population density areas in the Southeast and the Mid-Atlantic.
“To succeed in the market today, Medicare health plans need to be efficient, reasonably priced, and focused on quality metrics,” Dan Mendelson, chief executive officer of Avalere Health, said in a statement. “There will inevitably be some plans that can’t survive in this demanding environment, and others that enter precisely because their operations are prepared to meet the challenge of public programs.”