Report: Premium hikes for top Medicare drug plans

Posted: September 27, 2012

WASHINGTON - Millions of seniors enrolled in some of the most popular Medicare prescription drug plans face double-digit premium hikes next year if they don't shop for a better deal, says a private firm that analyzes the highly competitive market.

Seven of the top 10 prescription plans are raising their premiums by 11 percent to 23 percent, according to a report this week by Avalere Health.

It's a reality check on a stream of upbeat Medicare announcements from the Obama administration, all against the backdrop of a hard-fought election. In August, officials had announced that the average premium for basic prescription drug coverage will stay the same in 2013, at $30 a month.

The administration's number is accurate as an overall indicator for the entire market, but not very helpful to consumers individually since it does not reflect price swings.

"The average senior is going to benefit by carefully scrutinizing their situation, because every year the market changes," Avalere president Dan Mendelson said. Avalere analyzed the numbers based on bid documents the plans submitted to Medicare.

The report found premium increases for all top 10 prescription drug plans (PDPs). However, the most popular plan - AARP MedicareRx Preferred - is only going up 57 cents per month nationally, from the current $39.85 to $40.42.

The Affordable Care Act does not appear to be the cause of the increases. Indeed, the law is improving the prescription benefit by gradually closing a coverage gap called the "doughnut hole," which catches people with high drug costs. Instead, the price hikes appear to be driven by market dynamics, and some insurers are introducing low-premium options to gain a competitive advantage on plans that are raising their prices.

The seven plans with double-digit premium increases were: Humana Walmart-Preferred Rx Plan (23 percent); First Health Part D Premier (18 percent); First Health Part D Value Plus (17 percent); Cigna Medicare Rx Plan One (15 percent); Express Scripts Medicare-Value (13 percent); HealthSpring Prescription Drug Plan (12 percent); and Humana Enhanced (11 percent).

Two other plans in the top 10 had single-digit increases. They were SilverScript Basic (8 percent) WellCare Classic (3 percent).

On the plus side for consumers, a major new low-cost plan entered the market. Premiums for the AARP MedicareRx Saver Plus Plan will average $15 a month nationally, although it won't be available everywhere. That's $3.50 less than the current low-cost leader, the Humana Walmart plan, whose premiums are rising to $18.50.

The new AARP plan is run by UnitedHealth Group Inc., the nation's largest health insurance company. United pays AARP for the right to use its name on a range of Medicare insurance products, a strategy that has proven lucrative for both partners. When Humana and Walmart teamed up to offer their low-cost plan in 2011, United felt the competition.

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