A shrinking number of Medicare Part D drug plans is set to bring beneficiaries some more low-cost choices, but also some potentially confusing benefit designs.
Average monthly premiums for standable alone Part D plans are falling, thanks in large part to consolidation of product offerings by the likes of Aetna, Cigna, CVS and UnitedHealth, according to a new analysis by Avalere Health.
Researchers at Avalere combed through the Centers for Medicare & Medicaid Services' Part D "landscape files" for 2015, and found that the number of standable drug plans is shrinking by 14 percent, from 1,169 this year to 1,001 next year.
Some significant plan withdrawals are already happening in fairly populated areas of the Southeast and Mid-Atlantic, but it's in rural areas -- like Vermont and New Hampshire -- where the small number of plan exits is affecting large market swaths, Avalere senior manager Christine Harhaj found.
These consolidations are poised to shift a large number of beneficiaries into lower-cost plans and bring down average premiums by as much as two percent, from $39.88 to $38.95, Harhaj found.
Five of the top 10 Part D plans will have average monthly premiums below $30 next year, the study found. Aetna's new product with CVS, Medicare Rx Saver, is consolidating a previous plan whose premiums will be reduced by 31 percent, while CVS's SilverScript Choice is being reduced by 21 percent.
But others will go up. Premiums for WellCare's Classic plan are increasing by 52 percent, Humana's Walmart Rx by 24 percent, and the AARP's Saver plan by 21 percent.
Even though premiums are onthe decline, there is a small trend toward more cost-sharing, Avalere found.
This year, 47 percent of Part D plans had $0 deductibles -- by next year, that number will be around 42 percent. At the same time, only a quarter of Part D plans are still offering coverage for drugs in the "donut hole" gap.
"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," Harhaj said in a media release.
The consolidation may partly be explained by plan sponsors looking to combine enhanced plan offerings to reduce the number of the PDPs in their portfolio, Harhaj argued. Another explanation, she said, is that others may be preparing for the possibility that CMS will "impose stricter limits on the number and type of PDPs sponsors can offer in the future under the so-called meaningful differences policy."