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Beyond the Numbers:

Virginia’s 2012 Medicare Part D plan choices in plain text

Based on the 2012 Medicare Part D plan information released by the Centers for Medicare and Medicaid Services (CMS), Virginia seniors and Medicare beneficiaries will find that 2012 will bring a number of changes to prescription drug coverage and they should be prepared to examine their current 2011 plans closely to see what changes are on the horizon for 2012.

Please note that the information we provide below is based only on stand-alone Medicare Part D prescription drug plans (or PDPs).  As many people know, a number of the Medicare Advantage plans also include comprehensive prescription drug coverage, along with Medicare Part A (hospitalization) and Medicare B (physician) benefits (also called MA-PD plans).  However, because MA-PDs include many additional features (including Part A & B coverage) as compared to a stand-alone Medicare Part D plan, we do not try to compare the stand-alone drug plans directly with MA-PDs.

What is new for 2012 Medicare Part D Prescription Drug Plans?

First, the number of prescription drug plans available in Virginia has decreased.
However, Fourteen (14) companies will offer 2012 Medicare Part D plans in all states across the country.  In addition, a wide assortment of regional and local Medicare Part D plans are offered within each state or CMS region, with the average number of prescription drug plans offered per state decreasing from 33 plans in 2011 to 31 plans in 2012.

Locally, Virginia residents will find that the total number of stand-alone Medicare prescription drug plans has decreased from 32 in 2011 to 30 in 2012.

As a note, if you find that your current 2011 Part D plan is not being offered in 2012, 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 2012 prescription drug plan or whether you will need to actively choose a new Medicare Part D plan for 2012.

58% of Virginia seniors can expect to see their monthly prescription drug plan premiums increase in 2012 although the average monthly permium will decrease.
Across the country, the national average monthly Medicare Part D premium will decrease from $55.36 in 2011 to $53.99 in 2012.  Even so, based on the 2011 enrollment figures, 55% of Medicare Part D beneficiaries nationwide (over 9 million people) could experience an average increase in premium of $4.99, unless they switch to a lower priced plan.  At home, Virginia residents will also notice a decrease in their Medicare Part D premiums.  Even with the decrease, 58% of Virginia seniors and other Medicare beneficiaries enrolled in a stand-alone Medicare Part D plan, (or around 244,730 people) will see an average increase in monthly premiums of $4.47 in 2012 -- if they do not switch to a lower cost prescription drug plan.  Overall, monthly 2012 prescription drug plan premiums in Virginia will decrease 2.24% from a 2011 average monthly cost of $54.12 to a 2012 average Part D plan premium of $51.88.

The average monthly premiums discussed above treat all Medicare Part D plans equally.  Perhaps a more telling average is the weighted average - that is, looking at each plan’s monthly premium based on number of people enrolled in that plan.  Based on the weighted average, Virginia residents can expect to see a 1% reduction in their monthly premiums. This means that if everyone stays in their current 2011 prescription drug plan through 2012, then across the state we can expect beneficiaries to pay 1% less for their monthly premium.

The range of monthly drug plan premiums will decrease.
Across the country, 2012 Medicare Part D plan premiums range from a low of $15.10 (Humana Walmart-Preferred Rx Plan (PDP) in WI) to a high of $131.80 (BlueRx Enhanced (PDP) in DC DE MD) .  Comparatively, the premiums within Virginia will range from $15.10 (Humana Walmart-Preferred Rx Plan (PDP) in VA) to $118.70 (Blue MedicareRx Premier (PDP) in VA) - as compared to the 2011 Virginia monthly premium range of $14.80 to $107.30.  Of those 2012 plans, 2 plan(s) will have a premium under $25 (in 2011, 1 Part D plan(s) were offered in Virginia with a premium under $25). 

Fewer Medicare prescription drug plans will offer some level of coverage gap protection.
The selection of prescription drug plan coverage options has also changed with fewer companies offering 2012 Part D plans with donut hole coverage.  In 2011, 12 plan(s) offered plans with some form of donut hole coverage and in 2012 that number will decrease to 8.  People are reminded to see what drugs are actually covered in the donut hole because some Part D plans only cover a "few" drugs through the coverage gap.

The same number of Medicare prescription drug plans will offer plans with enhanced options.
Virginia residents will find that 15 Part D plans will offer enhanced prescription drug coverage options.  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 2012, more Virginia Part D plans will offer prescription drug coverage with a $0 initial deductible (15 in 2012 as compared to 13 in 2011).

Low-Income Subsidy Recipients in Virginia will have the same number of Part D plans that qualify for the $0 monthly premium.
Virginia 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 2011, 10 Medicare Part D plans qualified for the $0 premium Low-Income Subsidy and this number (10) does not change for 2012.  Please note, if you received "Extra Help" in 2011 and your plan does not qualify for the $0 premium in 2012, 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 they are not, you can switch to a plan which will cover your medications.

So what is the Bottom Line? Review your 2012 Medicare prescription drug plan options.
Virginia seniors and Medicare beneficiaries will see fewer prescription drug plan choices in 2012 and lower premiums. 

In addition, behind the numbers, some of 2011’s more popular Medicare Part D plans will change their 2012 plan structure.  Some plans are adding initial deductibles or changing cost-sharing limits (for instance, how much you pay after for a covered drug).  Also, some plans actually change the initial coverage limit defining when you enter the coverage gap. 
  Accordingly, people are reminded to consider their 2012 prescription drug plan options carefully.  If you are a Medicare beneficiary and make no decision to change 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 coverage or cost for 2012.  If your prescription drug plan is discontinued, and you are not automatically moved into a new plan, then you will need to enroll in another Part D plan or not have prescription drug coverage in 2012. 

For more information, Q1Medicare.com has developed national and state one-page interactive summaries of prescription drug plan information.

Questions? Please let us know by clicking here for our Customer Help Desk.

Click here to review Medicare Part D plan statistics for the 2012 plan year.

: : Charts & Figures   : : Summarized in Plain Text   : : Print Version