So do I really need to enroll into a Medicare Part D prescription drug plan?
What if I currently don’t take any medication and don’t need prescription coverage? Medicare Part D is a voluntary program – with an incentive to enroll when you are first eligible for Medicare (the late-enrollment penalty). As some people who use no prescriptions note: “Medicare Part D is simply insurance against future uncertainty – like car or home insurance”. The downside to not enrolling is that if you do not enroll when you are first eligible, you may be subject to a life-time Late-Enrollment Premium Penalty when you decide later to enroll in a Medicare Part D plan.
Click Here to Read more about the Medicare Part D Late-Enrollment Premium Penalty The Premium Penalty – The High Cost of Waiting
Pennsylvania’s 2017 Medicare Part D plan overview
Based on the 2017 Medicare Part D prescription drug plan information released by the Centers for Medicare and Medicaid Services (CMS), Pennsylvania seniors and Medicare beneficiaries will find that 2017 will bring a number of changes to their prescription drug coverage and beneficiaries should be prepared to see how their current 2016 Medicare Part D plan is changing in 2017. To assist, we now have our 2017 PDP-Compare Annual Notice of Change (ANOC) tool online to show basic changes in plan coverage at PDP-Compare.com/2017/PA.
Please note that the information we provide below is based only on stand-alone Medicare Part D prescription drug plans (PDPs). We do not compare stand-alone drug plans directly with Medicare Advantage plans. Unlike PDPs, Medicare Advantage plans provide coverage for Medicare Part A (in-patient hospital coverage), Medicare B (out-patient physician visits), and may include comprehensive prescription drug coverage (called MAPD plans). Medicare Advantage plans may also include additional benefits such as dental, vision, and health club coverage. For more information, seniors can review all Medicare Advantage plans available in their area using our 2017 MA-Finder.
What’s new for Pennsylvania’s
2017 Medicare Part D Prescription Drug Plans
Pennsylvania 2017 Medicare Part D premium increases and decreases:
Of the 24 Medicare Part D plans available in Pennsylvania for 2017, 11 plan(s) will lower their premiums and 10 will increase their premiums. Currently, 68.8% of Pennsylvania residents enrolled in a stand-alone Medicare Part D plan are enrolled in one of the 10 plans with a premium increase. The average premium increase for members of these plans will be $7.55 per month.
The 2017 average monthly Medicare Part D premium in Pennsylvania will decrease:
Overall, the average monthly 2017 prescription drug plan premiums in Pennsylvania will decrease 2.02% from a 2016 average monthly premium of $59.18 to a 2017 average Part D plan premium of $57.16.
The average monthly premium discussed above consider all stand-alone Medicare Part D plans equally. Perhaps a more telling average is the weighted average — that is, looking at each plan’s monthly premium weighted by the number of people enrolled in that particular plan. Based on the weighted average, Pennsylvania residents can expect to see a 9% increase in their monthly premiums. This means that if everyone stays in their current 2016 prescription drug plan through 2017, then across the state we can expect beneficiaries to pay 9% more for their monthly premium.
As reference, the national average monthly Medicare Part D premium will decrease from $53.83 in 2016 to $51.96 in 2017. Even so, based on the 2016 enrollment figures, 64.9% of Medicare Part D beneficiaries nationwide (over 12 million people) could experience an average increase in premium of $8.06, unless they switch to a lower priced plan.
Pennsylvania will have fewer Medicare Part D (PDP) plan choices:
A wide assortment of national and regional Medicare Part D plans are offered in each state or CMS region, with the average number of prescription drug plans offered per state decreasing from 26 plans in 2016 to 22 plans in 2017. You can review all 2017 Medicare Part D Plans available in Pennsylvania at PDP-Finder.com/2017/PA.
Locally, Pennsylvania residents will find that the total number of stand-alone 2017 Medicare prescription drug plans has decreased from 29 in 2016 to 24 Part D plans.
As a note, if you find that your current 2016 Part D plan is not being offered in 2017, you may wish to review your Part D plan’s Annual Notice of Change (or ANOC) letter to see if you will be automatically moved to another 2017 prescription drug plan or whether you will need to actively choose a new 2017 Medicare Part D plan.
If you are automatically switched to a new plan for any reason, please review the new plan closely. Automatic plan switches DO NOT take into account your specific medication coverage and pharmacy needs. Check to be sure that your new plan provides the coverage you need.
The range of monthly drug plan premiums will increase:
The premiums within Pennsylvania will range from $14.60 (EnvisionRxPlus (PDP) in PA WV) to $170.60 (Blue Rx PDP Complete (PDP) in PA WV) — as compared to the 2016 Pennsylvania monthly premium range of $18.40 to $149.60.
In comparison, across the country the 2017 Medicare Part D plan premiums range from a low of $14.60 (EnvisionRxPlus (PDP) in SC) to a high of $179.00 (Anthem Blue MedicareRx Premier (PDP) in CO).
More Medicare Part D plans with a monthly premium under $25:
When reviewing lower premium Medicare Part D (PDP) plans, Pennsylvania residents will have more plans from which to choose. There will be 3 plans having a premium under $25, an increase from the 2 Part D plans offered in 2016.
All 2017 stand-alone Medicare Part D plans (PDPs) changed their initial coverage limit — defining when you enter the Coverage Gap.
More Medicare prescription drug plans will offer some level of Coverage Gap protection:
The selection of prescription drug plans with donut hole coverage has also changed with more companies offering 2017 Part D plans with some level of additional coverage (over the standard generic and brand-name drug discounts) for purchases made in the coverage gap. In 2016, 6 plans offered plans with some form of donut hole coverage and in 2017 that number will increase to 7 plans. People are reminded to see which drugs are actually covered in the donut hole because some Medicare Part D plans only cover a “few” drugs through the coverage gap.
Remember, even if your Medicare Part D plan has “No Gap Coverage”, you still get the standard 2017 generic drug discount of 49% and brand-name drug discount of 60%. You can read more Donut Hole Discount here.
Fewer Medicare prescription drug plans are offered with enhanced options:
Pennsylvania residents will find that fewer Part D plans will offer enhanced prescription drug coverage options with 12 enhanced Part D plans in 2017 as compared to 15 in 2016. Enhanced Medicare Part D coverage includes prescription drug plans that have a lower or no initial deductible and a variation of cost-sharing (for instance, copayments instead of co-insurance). For example, in 2017, fewer Pennsylvania Part D plans will offer prescription drug coverage with a $0 initial deductible (10 plans in 2017 as compared to 11 plans in 2016).
Low-Income Subsidy recipients in Pennsylvania will have the same number of Medicare Part D plans that qualify for the $0 monthly premium:
Pennsylvania Medicare beneficiaries who qualify for full “Extra Help” will find no change in the number of Part D plans qualify for the $0 premium Low-Income Subsidy as compared to last year. In 2016, 9 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy and this number (9 Part D plans) does not change for 2017.
Please note, if you received “Extra Help” in 2016 and your plan does not qualify for the $0 premium in 2017, you may be automatically moved to a new Part D plan that does qualify for the $0 premium. If this occurs, please check to be sure that your prescriptions are covered on your new plan. If your prescriptions are not covered, you can switch to a plan that will cover your medications.
Pennsylvania seniors and Medicare beneficiaries will see fewer prescription drug plan choices in 2017 and can expect to see higher monthly premiums.
In addition, behind the numbers, some of 2016’s more popular Medicare Part D plans will change their 2017 plan structure. Some plans are adding initial deductibles or changing cost-sharing limits (for instance, how much you pay for a covered drug).
Accordingly, beneficiaries are reminded to consider their 2017 prescription drug plan options carefully. If you are a Medicare beneficiary and make no decision about changing your existing prescription drug coverage, you will be automatically reenrolled in your existing prescription drug plan — along with any changes that have been made in your plan’s coverage or cost for 2017. If your prescription drug plan will be discontinued, and you are not automatically moved into a new plan, you will need to enroll in another Part D plan or you may not have prescription drug coverage in 2017.
What is the Bottom Line?
Review your 2017 Medicare prescription drug plan options.
Medicare Part D Plan Marketing begins: October 1, 2016
Annual Open Enrollment Period: October 15, 2016 through December 7, 2016
New Coverage begins: January 1, 2017
For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information. You can review the 2017 Pennsylvania Medicare Part D Facts page at PDP-Facts.com/2017/PA
Questions? Please let us know by clicking here for our Customer Help Desk.
Click here to review Medicare Part D plan statistics for the 2017 plan year.