SummaryOn July 31, CMS released Calendar Year (CY) 2015 regional and national benchmarks that help determine beneficiary premiums in Medicare Part D, including the regional low-income subsidy (LIS) amounts.
The average Part D plan bid is approximately eight percent lower in 2015 compared to 2014. The 2015 average premium for standard Part D coverage is expected to be approximately $32 per month, a $1 increase from 2014.
The decreasing average bids and the consistent base beneficiary premiums highlight the continuing stability of the Part D program. The increasing enrollment in low-premium plan offerings, along with the expanded use of preferred pharmacy networks, are likely key factors in driving down average plan bids in the Part D benefit. These trends, however, have been subject to greater scrutiny by CMS over the past year and CMS may act to increase oversight or regulation on these types of plans in the near future.
The decline in the average bid counters recent projections that Medicare Part D costs would increase significantly in the near term. As more Part D plans offer low-cost plans with premiums less than $30, more restrictive formularies that typically require high cost-sharing for branded drugs are likely. Also, as more Part D beneficiaries migrate to these plans, manufacturers may see patient access to their products decline and encounter greater pricing pressures from Part D customers.
Additional information regarding 2015 premiums and plan offerings will become available when CMS releases the MA and Part D landscape files in Sept. 2014. Part D plan sponsors may begin marketing their plan offerings on Oct. 1. Open enrollment for Medicare beneficiaries begins Oct. 15 and ends on Dec. 7. The 2015 plan year begins Jan. 1, 2015.