California Medicare beneficiaries will have over thirty Part D Prescription Drug Plans (PDP) to choose from in 2014. But a recent Kaiser Family Foundation study found that upwards of 80% of individuals never switch their PDP even if new plans offer better coverage and a lower premium.
Part D Prescription Plan are challenging to compare
Part of the lack of change in PDPs might revolve around the daunting task of comparing the different plans. Once a Medicare beneficiary selects a plan and they don’t have any problems most people are reluctant to investigate the new plans and determine if there is any benefit to switching. However, with SilverScript and SmartD Rx PDPs on sanction, in part for poor customer service, many Californians might go shopping for a new PDP in 2014.
California Part D Prescription Plans
Thirteen insurance companies will offer thirty-two different Prescription Drug Plans in California for 2014. Several of the plans will offer a $0 premium with low income verification. For 2014, enhanced alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above and beyond the 2014 standard “generic” coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs. Review all the benefits of the plans at Medicare.gov
2014 Medicare Part D Stand-Alone Prescription Drug Plans
From the Centers for Medicare and Medicaid Services PDP Landscape files dated September 3, 2013. The list is subject to change.
| Insurance Co. | Plan | |
| Aetna Medicare | Aetna CVS/pharmacy Prescription Drug Plan (PDP) | Basic |
| Aetna Medicare | Aetna Medicare Rx Premier (PDP) | Enhanced |
| Anthem Blue Cross Life and Health Insurance Co | Blue Cross MedicareRx Gold (PDP) | Enhanced |
| Anthem Blue Cross Life and Health Insurance Co | Blue Cross MedicareRx Plus (PDP) | Enhanced |
| Anthem Blue Cross Life and Health Insurance Co | Blue Cross MedicareRx Standard (PDP) | Basic |
| Blue Shield of California | Blue Shield Medicare Basic Plan (PDP) | Basic |
| Blue Shield of California | Blue Shield Medicare Enhanced Plan (PDP) | Enhanced |
| Cigna Medicare Rx | Cigna Medicare Rx Secure (PDP) | Basic |
| Cigna Medicare Rx | Cigna Medicare Rx Secure-Max (PDP) | Enhanced |
| Cigna Medicare Rx | Cigna Medicare Rx Secure-Xtra (PDP) | Enhanced |
| Cigna-HealthSpring | Cigna-HealthSpring Rx -Reg 32 (PDP) | Basic |
| EnvisionRx Plus | EnvisionRxPlus Silver (PDP) | Basic |
| Express Scripts Medicare | Express Scripts Medicare – Choice (PDP) | Enhanced |
| Express Scripts Medicare | Express Scripts Medicare – Value (PDP) | Basic |
| First Health Part D | First Health Part D Essentials (PDP) | Basic |
| First Health Part D | First Health Part D Premier Plus (PDP) | Enhanced |
| First Health Part D | First Health Part D Value Plus (PDP) | Enhanced |
| HealthMarkets Medicare | HealthMarkets Value Rx (PDP) | Basic |
| Humana Insurance Company | Humana Enhanced (PDP) | Enhanced |
| Humana Insurance Company | Humana Preferred Rx Plan (PDP) | Basic |
| Humana Insurance Company | Humana Walmart Rx Plan (PDP) | Enhanced |
| Stonebridge Life Insurance Company | Transamerica MedicareRx Choice (PDP) | Enhanced |
| Stonebridge Life Insurance Company | Transamerica MedicareRx Classic (PDP) | Basic |
| Symphonix Health | Symphonix Rite Aid Value Rx (PDP) | Basic |
| United American Insurance Company | United American – Enhanced (PDP) | Enhanced |
| United American Insurance Company | United American – Select (PDP) | Basic |
| UnitedHealthcare | AARP MedicareRx Enhanced (PDP) | Enhanced |
| UnitedHealthcare | AARP MedicareRx Preferred (PDP) | Enhanced |
| UnitedHealthcare | AARP MedicareRx Saver Plus (PDP) | Basic |
| WellCare | WellCare Classic (PDP) | Basic |
| WellCare | WellCare Extra (PDP) | Enhanced |
Are Medicare Beneficiaries Switching Drug Plans To Save Money?
A recent KFF analysis of PDP enrollment between 2006 -2010 found that approximately of 13% PDP enrollees voluntarily switched plans. They found that those people who did switch lowered their monthly premium and their out-of-pocket costs as a result of the change in plans
- The relatively small share of PDP enrollees who switched plans at some point between 2006 and 2010 were more likely than those who did not switch to end up in a plan that lowered their premiums. Nearly half (46 percent) of enrollees who switched plans saw their premiums fall by at least 5 percent the following year, compared to 8 percent of those who did not switch plans. But those who switched plans were only slightly more likely than those who did not switch to face lower out-of-pocket costs for drugs during the year.
- Relatively large premium increases for a PDP from one year to the next were associated with higher rates of plan switching between 2006 and 2010; but most enrollees with relatively large premium increases (such as $10 or more per month) did not switch plans in any of the four annual enrollment periods.
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Medicare Part D: A First Look at Plan Offerings in 2014
A second KFF analysis found new Part D Prescription plans being offered and the average increase in premiums to be 5% for 2014.
- In 2014, Medicare beneficiaries will have a choice of 35 stand-alone PDPs, on average, up by four from 2013. The average premium (weighted by enrollment) is expected to increase by 5 percent across all PDPs from 2013 to 2014 unless many new or current enrollees select lower-priced plans. As in prior years, the average monthly premium for 2014 masks a significant amount of variation across plans. Enrollees in two of the most popular PDPs will experience 50-percent premium increases if they stay in the same plans in 2014, while enrollees in three other popular PDPs will see lower premiums. ADDED EMPHASIS
- The majority of plans offered in 2014 will offer no gap coverage beyond that which is required by the Affordable Care Act (ACA) of 2010, which phases out the coverage gap by 2020. Under current law, for 2014, manufacturer prices for brand-name drugs purchased in the gap will be discounted by 50 percent (with plans paying 2.5 percent and enrollees paying the other 47.5 percent), and plans will pay 28 percent of the cost for generic drugs in the gap (with enrollees paying 72 percent).
- Notable trends for 2014 include a growing share of PDPs using preferred pharmacy networks and adopting more formulary cost-sharing tiers. For example, a majority of PDPs now use preferred pharmacy networks where cost sharing is lower when enrollees use preferred pharmacies and higher outside the preferred network. In 2006, few PDPs used this type of pharmacy network.
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Prescription plans still good value
Medicare Part D Prescription Plans continue to offer stable and predictable costs for their members. Even though the number of plans has dropped from a high of 1,875 in 2007 down to 1,169 in 2014, the premiums and benefits have remained relatively stable in the new PDP offerings. But as the Affordable Care Act regulations will substantially close the coverage gap in 2020, new plans are offered to reflect the changes. The down side is that Medicare beneficiaries who don’t shop their options during open enrollment may find their premiums are higher than the newer plans being offered.
See also: California Medicare Advantage Plans 2014 by county