Tag Archives: medicare prescription drug plans

Latest Medicare Enroll News

Volunteers ready to assist with Medicare enrollment
During the month of October, we begin the annual enrollment process for the Medicare prescription drug plans, as well as Medicare Advantage plans. From Oct. 15 through Dec. 7, Medicare beneficiaries will have the chance to enroll, add or change plans …
Read more on Newport News Times

CVS/pharmacy to Help Patients Save Time and Money During Annual Medicare
WOONSOCKET, R.I., Oct. 14, 2014 /PRNewswire/ — CVS/pharmacy, the retail division of CVS Health , announced today that it will offer its senior patients an easy way to compare Medicare Part D prescription drug plans during the Annual Enrollment Period …
Read more on The Providence Journal

Hunterdon County reminds seniors about 2015 medicare open enrollment
Hunterdon County reminds seniors that the 2015 Medicare Open Enrollment period runs Oct. 15 to Dec. 7. Each year plans change, including what they cost and what they cover. Those who don't have prescription drug coverage can also enroll in a drug plan …
Read more on Hunterdon County Democrat

New Milliman Study: Hepatitis C Drugs Could Increase Medicare Part D Spending by $2.9 to $5.8 Billion in 2015

Washington D.C. (PRWEB) July 29, 2014

New high priced hepatitis C drugs will increase federal spending in Medicare Part D by a projected $ 2.9 to $ 5.8 billion next year, according to a new report by the actuarial firm Milliman released today by the Pharmaceutical Care Management Association (PCMA). Milliman projects that average Part D premiums could increase by as much as 8.6 percent in 2015 as a result of high-priced hepatitis C drugs, including Sovaldi and Olysio.

The study finds that the majority of new Federal spending will come from increased federal reinsurance subsidies. Medicare payments for Part D catastrophic coverage have grown considerably faster than other components of Part D spending. According to the Medicare Payment Advisory Commission, between 2007 and 2012, payments have increased at an average annual rate of 14 percent while nearly doubling from $ 8 billion to $ 15.6 billion.

Milliman bases its cost projections on the assumption that 15 percent to 30 percent of the Medicare Part D population estimated to be infected with hepatitis C will receive an $ 84,000 course of treatment in 2015.

“While most payers cover about 75 percent of an enrollee’s prescription drug costs, Medicare Part D covers 95 percent at high spending levels,” said PCMA President and CEO Mark Merritt. “The study shows taxpayers will bear the lion’s share of the increased drug costs for Medicare Part D beneficiaries taking hepatitis C drugs.”

Click here to read the new report.

Major findings from the report include:


    New hepatitis C drugs, including Sovaldi and Olysio, will increase 2015 federal spending on Medicare Part D by $ 2.9 to $ 5.8 billion for beneficiaries enrolled in Medicare Prescription Drug Plans (PDPs), an increase of $ 100 to $ 200 per beneficiary per year.

    Average monthly premiums for Medicare PDPs are projected to increase 4.3 percent to 8.6 percent next year as a result of new hepatitis C drugs, an increase of $ 17 to $ 33 per beneficiary per year.

Milliman’s analysis measured the impact of these new drugs on the Medicare Part D program; the study did not include the effect of the drug therapy on other medical costs.







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PCMA on New Study: Medicare Preferred Pharmacy Network Plans Offer Lower Average Premiums, Same Quality as Non-Preferred Network Plans

Washington, D.C. (PRWEB) December 11, 2013

Medicare prescription drug plans (PDPs) using preferred pharmacy networks have lower average premiums and the same or better average quality ratings as plans without preferred networks, according to a new analysis by Avalere Health released today by the Pharmaceutical Care Management Association (PCMA). The analysis is the first to examine 2014 premiums and star ratings for PDPs with preferred pharmacy networks, which now account for around 70% of Part D enrollment.

“Preferred pharmacy plans can offer Medicare beneficiaries the same quality at less than half the premium of plans without preferred networks,” says PCMA President and CEO Mark Merritt.

Click here to read the new analysis.

Avalere analyzed recently released CMS data on 2014 premiums and star ratings for Medicare PDPs. Key findings include:


    Premiums: On average, PDPs with preferred pharmacy networks have lower premiums than PDPs without preferred networks.

o    For basic PDPs, the average monthly premium for plans with preferred networks is $ 29.83, 17% less than for plans without preferred networks.

o    For enhanced PDPs, the average monthly premium for plans with preferred networks is $ 49.15, 57% less than for plans without preferred networks.

o    For all PDPs offered in 2014, the top seven plans with the lowest average monthly premium all use preferred pharmacy networks.

    Quality (Star Ratings): On average, PDPs with preferred pharmacy networks have similar star ratings compared to PDPs without preferred networks.

o    Basic PDPs with preferred networks have an average star rating of 3.3, compared to 3.0 stars for basic plans without preferred networks.

o    Enhanced PDPs with preferred networks have an average star rating of 3.5, the same as enhanced PDPs without preferred networks.

The Avalere analysis adds to a growing body of evidence demonstrating the value of preferred pharmacy networks for the Medicare program and its beneficiaries.

A recent study by Milliman estimated that preferred pharmacy network plans will reduce federal Medicare spending by $ 7.9 to $ 9.3 billion over the next 10 years. Milliman found that the largest two-year decrease in federal direct subsidies in the history of the Part D program has coincided with the rapid adoption of preferred pharmacy network plans and the increased use of generic drugs.

Separately, Part D seniors in plans with preferred pharmacy networks are overwhelmingly satisfied, citing lower costs, convenient access to pharmacies and other benefits, according to a survey from Hart Research Associates. The survey found that 85 percent of seniors surveyed are satisfied with their preferred network plan. In addition, the survey found that four in five seniors would be disappointed if their preferred network plan is eliminated.

Currently there are more drugstores in the U.S. than McDonald’s, Burger Kings, Pizza Huts, Wendy’s, Taco Bells, Kentucky Fried Chickens, Domino’s Pizzas, and Dunkin’ Donuts combined, creating a highly competitive environment.







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