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Medicare Part D Open Enrollment: Higher Premiums for Beneficiaries Only the Beginning

It’s that time again: open enrollment for Medicare Part D. Ordinarily, items such as this don’t really generate newsworthiness. However, these aren’t ordinary times; given the state of the (healthcare) economy, anytime one connects the dots between the country’s largest care guarantor and the potential for greater coverage pools — it’s time for intense wonkishness to rear its ugly head yet again.

The big question is whether or not Part D makes sense for the consumer. New this enrollment period: (1) premiums will rise another 10% percent;[1] (2) the vast majority of standalone prescription drug plans (60% or so) will require a deductible in ’10, maxing out at just over $300; (3) finally, with respect to so-called “benchmark” plans,[2] qualified beneficiaries will still have to pony up a percentage of their premium if they want to stay in their plan or will have to switch plans altogether.

Bottom line, it’s all about cost-sharing as a mechanism for controlling costs, at least with respect to Pharma and Medicare Advantage plans; and, in a pharma marketplace which is forecasted to remain rather staid next year,[3] profits have to be generated from many levels. Medicare Part D has its share of choices for the beneficiary, but due diligence will be the guide to retaining skin in the game for the patient as savvy health care consumer. | LINK

  1. up 50% overall from when MMA (2003) created the part D provision for launch in ’06 []
  2. those in which basic Part D is offered for those who qualify for a premium []
  3. Many popular brand name medications are scheduled for generic release in 2010. []

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  2. Budget Office: Medicare Drug Premiums Increase; Aim Is to Cut Medicare Drug Spending By law, income from Social Security is guaranteed never to...
  3. Michigan Blues Set to Negotiate Payer Mix of Sorts in Beneficiaries’ Medigap Plans BC/BS Michigan is asking that state’s insurance regulators to vary...

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