Keeping you updated on the latest Medicare and Part D news

2016 Medicare Part D Benefit Design and Cost Sharing

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Last week’s Medicare Part D in 2016 and Trends over Time report from the Health Policy Institute at Georgetown University and the Kaiser Family Foundation found that most PDP and MA-PD enrollees in 2016 were in plans with tiered pharmacy networks, no additional gap coverage, enhanced benefits, 5 tier formularies, and low deductibles.  PDPs and MA-PDs differ in some significant categories though – a much larger percentage of MA-PD enrollees are in enhanced plans and more PDP enrollees are in plans with tiered pharmacy networks.


The report also found that close to 60% of beneficiaries enrolled in PDP plans have plans that offer only the basic benefit. This is down from 83% a decade earlier.  Additionally, about half of all enrollees in 2016, in PDPs and MA-PDs, are in plans that do not charge the Part D deductible.  Tiered pharmacy networks have grown in recent years and are now the new norm in PDP plans.


8915-exhibit-3-13.pngNext week we will conclude this exploration of the Medicare Part D in 2016 and Trends over Time report by digging deeper into the Low Income Subsidy and Plan Performance Ratings.


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