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Q1Group 2016 PDP Analysis: Fewer stand-alone 2016 Medicare Part D prescription drug plan choices

Category: Annual Medicare Plan Changes
Published: Sep, 24 2015 02:09:27


According to the recently released Centers for Medicare and Medicaid Services (CMS) Medicare Part D landscape data, most Medicare beneficiaries will have slightly fewer stand-alone 2016 Medicare Part D prescription drug plan choices.

As was true last year, on average, there will be fewer 2016 stand-alone Medicare Part D prescription drug plan (PDP) choices.   In 2016, the average number of stand-alone Medicare Part D plans offered in each state dropped to an average of 26 stand-alone PDPs from an average of 29 stand-alone Part D plans available in 2015.

In comparison to past years, there were an average of 34 stand-alone 2014 Medicare Part D plans (not including Medicare Advantage plans), 31 stand-alone 2013 Medicare Part D plans, and, back in 2009 - an average of 49 stand-alone Medicare Part D plans offered in each CMS PDP region (see chart below).

150924_PDP_Number.jpg

The Highs
Pennsylvania and West Virginia will have the largest selection of 2016 stand-alone Medicare Part D plans (again offering Medicare beneficiaries 29 PDPs).

The Lows
As was true in 2015,  Alaska Medicare beneficiaries will again have the smallest selection of 2016 stand-alone Medicare Part D plans (19 PDPs - down from 24 PDPs in 2015).

Largest Changes
Alaska, Illinois, and Florida will see the largest decrease of stand-alone Medicare Part D plans in 2016 with each state losing 5 PDP choices.   In 2015, Illinois was the state having the largest selection of stand-alone Medicare Part D plans (33 PDP plans).

A detailed overview of the 2016 Medicare Part D landscape data can be found in the Q1Medicare.com PDP-Facts section with Part D plan summaries on a national and state level.

Please note that we will continue to update the Medicare Part D plan coverage details throughout the year as more information becomes available.

Reminder: No need to rush.
Medicare Part D plan carriers can start marketing their plans on October 1st and the annual Medicare Open Enrollment Period for 2016 Medicare Part D plans and Medicare Advantage plans begins on Thursday, October 15th and continues through Monday, December 7th, with 2016 Medicare plan coverage beginning on Friday, January 1, 2016.

For more information, starting October 1st, Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about their 2016 Medicare Part D and Medicare Advantage plan options.

Please note: The 2016 Medicare Advantage plan landscape summary will be presented separately in another article. The above information is from our Medicare Part D plan landscape summaries and based only on stand-alone Medicare Part D prescription drug plans (or PDPs).

A number of the 2016 Medicare Advantage plans may be available in your area and may include comprehensive prescription drug coverage, along with Medicare Part A (hospitalization), Medicare Part B (out-patient and physician), and additional healthcare benefits (these Medicare plans are also called MAPD plans).

Not sure where to begin with all this information or you have a question for us?  No problem, click here to let us know.






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Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.