Part D Premiums Update: What You Need to Know

  • This page as PDF


On July 31, the Centers for Medicare & Medicaid Services (CMS) announced that the base Part D premium will be $35 for 2018.
Please note: This is an archived post. Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions. Please see our main Insights section for more recent posts.

The CMS premium calculation is based on bids submitted to CMS by Part D plan sponsors in early June. Avalere experts note that the average Part D plan premium will drop slightly for 2018, for the first time in 5 years.

Avalere experts find that the slight decrease in the base Part D premium is driven by two factors—lower expected costs for individuals who will not reach catastrophic coverage and slightly lower predicted costs for individuals who will have high spending above the catastrophic threshold. Most recently, reinsurance costs have increased dramatically, leading to increases in Part D premiums for the last few years. Reinsurance covers high-cost beneficiaries who reach catastrophic coverage. According to CMS, higher reinsurance costs had been driven by high-cost specialty drugs.

To receive more expert insights on the latest healthcare news, connect with us.

Webinar | Election 2024: What’s at Stake for Healthcare? 

On August 14 at 1:30 PM ET, Avalere experts and guests will discuss the 2024 elections, exploring the candidates’ health policy approaches and implications for stakeholders. 

Learn More

From beginning to end, our team synergy
produces measurable results. Let's work together.

Sign up to receive more insights about Federal and State Policy
Please enter your email address to be notified when new Federal and State Policy insights are published.

Back To Top