Medicare Advantage

Medicare Enrollment 2016 & Prescription Drug Plan Costs

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As time is winding down for seniors to change their health insurance plans during the open enrollment period, which ends December 7th, many are discovering for the first time that their costs are going up and if they want to switch plans they have fewer to choose from.

It’s Not Too Late For Seniors to Find a Better Priced Health & Rx Drug Plan For 2016

Medicare beneficiaries across America are seeing rising premiums, higher deductibles, and more costly out-of-pocket expenses. The Obama administration has been putting out a strong message to consumers on the importance of “shopping around” to get better prices and coverage this enrollment period, namely due to the rising costs, but also because even though there has been a loss of insurers and fewer plan options the administration insists there are still plenty of plans available to seniors and by shopping around they can possibly save money and get better coverage.

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Unfortunately, seniors tend to stick with the familiar, even if it means paying more for their coverage or prescription drug costs. Many seniors are on very fixed incomes and some of the increases in healthcare costs to seniors can be life altering in their quality of life when trying to pay for the increasing costs of deductibles and prescription drugs. So, the message seniors really need to hear is that they need to break that trend and shop around for their health and prescription drug insurance plan, especially this year.

In 2016 The Government Is Focusing on Prescription Drug Costs

Medicare Part D’s prescription drug plans are a big focus for the Obama administration this year as it serves almost 40 million of the country’s elderly and disabled citizens and has seen government spending rise dramatically this year alone. In the spotlight is the Hepatitis C infection, for which the government estimates its drug costs to be $9.2 billion dollars for 2015, nearly twice the amount of costs in 2014.

According to the CDC’s statistics three out of four adult people with the hepatitis C infection are baby boomers, who are now entering into the Medicare enrollments. Under Medicare Part D expensive drugs, like the medications for hepatitis C, are mostly paid for by taxpayers. The same is true for people under Medicare Part D’s “catastrophic” portion of coverage under which beneficiaries pay only five percent of the cost of the drug(s) they are taking. Government, taxpayer paid for, spending for catastrophic coverage has risen from $15.5 billion dollars in 2012 to a whopping estimated $31.2 billion dollars for 2015. But, the Obama administration insists that drug plan premiums will be at an average of $32.50 per month, remaining stable in 2016, something independent Medicare experts in the field disagree with.

Why There is Conflicting Opinions on Cost Increases to Seniors

On a national basis the top ten supplemental prescription drug plans will see an increase of about $13 dollars a month on premiums, according to the Kaiser Foundation. Stand-alone or independent drug plans will see average premium increases of 13 percent and according to consulting firm Avalere Health, even people who switch to lower cost plans will still see the highest increases since 2009.

Beneficiaries will also see the largest increase, since Part D’s inception in 2006, in their maximum deductible amounts, an increase of forty dollars which brings the deductible amount to a record $360.00 dollars; this is the amount beneficiaries must pay up front each year before their insurance will pick up any costs.

The reason for the conflicting conclusions is because the Obama administration calculates its number of people impacted based on the assumption that people will switch to plans with lower costing premiums, which is likely why they are spending so much money and attention on encouraging seniors to shop around.

The independent Medicare experts like the Kaiser Foundation and Avalere Health do not base their findings on hypothetical (assuming people will switch plans) situations, their findings are based on what is actually occurring to the premium costs of the plans that beneficiaries are actually enrolled in.

One of the most widely chosen supplemental drug plans offered by AARP MedicareRx Preferred will see an increase of 21 percent this year, rising from $50.19 to $60.79. And yet the deputy administrator at the Centers for Medicare and Medicaid Services, Sean Cavanaugh believes that the administration has a good record on estimating health care projections saying, “We do think ours is more illustrative of what beneficiaries actually experience.” “The challenge in the Part D program is around high-cost specialty drugs.” “We certainly have to be concerned about anything that’s driving that much cost in our program.”

Prescription Drug Costs In 2016

Consumer advocates still recommend shopping around, and for those who are not all that familiar with insurance industry terms it is strongly urged to seek help from a free non partisan insurance facilitator whose goal is to help connect you with insurance providers that are best for your “specific” health care coverage needs. And while advocates are somewhat skeptical that seniors shopping around will completely diminish the premium increases to seniors, it is believed it can be of important assistance for many and simply requires a bit of time to do that shopping or making use of the free help from an insurance facilitator.