The Centers for Medicare & Medicaid Services has announced that average 2011 Medicare prescription drug plan premiums will remain similar to rates paid by beneficiaries this year.
CMS officials said this, coupled with new discounts for brand-name drugs through the Affordable Care Act, will help make medications more affordable for Medicare beneficiaries.
"Most Medicare prescription drug plan premiums should remain relatively stable next year, and all beneficiaries should compare their coverage under their current plan with the plans that will be offered in 2010 when that information becomes available in October," said Jonathan Blum, deputy administrator of CMS' Center for Medicare. "The Affordable Care Act improves the value of drug coverage people with Medicare will receive next year, providing discounts on brand name drugs and coverage of generics in the coverage gap, or donut hole."
Based on the bids submitted by Part D plans for the 2011 plan year, CMS estimates that the average monthly premium that beneficiaries will pay for standard Part D coverage will be $30 – a $1 increase from the current year (2010) average premium of $29.
Pharmaceutical Care Management Association officials said the latest reduced CMS Part D cost estimate highlights that proven pharmacy benefit management tools used by Part D plans are saving money without sacrificing beneficiaries' prescription drug choices.
"As Medicaid expands under the Affordable Care Act, policymakers should explore the Part D model for consumer-friendly ways to reduce wasteful spending in Medicaid pharmacy," they said.
The premiums paid by Part D enrollees cover about 25 percent of the cost of basic Part D coverage. Enrollees with limited incomes may qualify for the low-income subsidy or extra help that typically covers some or all of the beneficiary's premium, deductible, co-payments and the cost of drugs in the coverage gap. Currently, more than 10 million beneficiaries are receiving LIS benefits.
According to CMS, in 2011, the average value of the subsidy amount applied to the Part D benefit, premium and cost-sharing for those enrolled in the LIS program is estimated to be about $4,000.
Under new Affordable Care Act provisions, fewer individuals who receive LIS benefits will need to move to a new plan to avoid paying a premium.
"The Affordable Care Act helps reduce disruption for this vulnerable population, so only about 500,000 beneficiaries will be re-assigned to new plans, compared to about 800,000 who were moved last year," Blum said. "And this year, we'll be providing those beneficiaries who are moved into a new plan with more information than ever before about how these plan changes may affect them. For most people with Medicare, we expect the process to be seamless."