Fee For Service Medicare Part D Price Increases

I am late on the draw for this information on Medicare. Been busy with other issues. Had dinner last night at VA’ Bene, a restaurant in Chandler which is not too far from us. An older couple joined us afterwards as we were sipping some Chianti. The heat finally got to this couple and they are moving back to Oregon after living here for twenty years.

Medicare Part D in 2024: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing, KFF.

Juliette Cubanski and Anthony Damico, November 8, 2024

The Inflation Reduction Act includes a premium stabilization provision capping annual growth in the Part D base beneficiary premium at 6%. However, the law did not apply this 6% cap to Medicare FFS individual plan premiums enrollees pay. Hence in Arizona etc., United Healthcare Part D Plan went from $28/month to $47/month or sixty-seven percent is the increase. PDP = “Prescription Drug Plan” and is associated with Fee For Service Medicare. The Michigan increase was higher.

I keep resisting going into the Medcare Advantage light no matter what any authority says. The overall cost, waste, and “denials” in MA plans is too great.

KFF: The estimated average enrollment-weighted monthly premium for Medicare Part D stand-alone drug plans (FFS Medicare) is projected to be $48 in 2024, based on current enrollment, up 21% from $40 in 2023. This increase is driven by higher expected plan costs to provide the Part D benefit in 2024, including a new cap on enrollees’ out-of-pocket spending above the catastrophic threshold rather than requiring them to pay 5% coinsurance, as in prior years. After accounting for enrollment choices by new enrollees and plan changes by current enrollees, the actual average weighted PDP premium for 2024 is likely to be lower than the estimated weighted average of $48.

Comparing MA plans to FFS Medicare plans for Part D.

Part D cost-sharing does not count towards an MA plan MOOP. From what I read, Part D is separate from the MA Plan (Part C) itself and is called out as Part D. This is getting a little bit convoluted in terms of Part D drug coverage and how it is paid for by MA plans in turn comes from the patient in some form or another.

In the state of Arizona, the United Healthcare FFS Medicare Part D Plan went from $28/month to $47/month. Sixty-seven percent sounds about right for the increase. Back in Michigan, the new 2024 rate was higher in my old zip-code. When I asked why the large increase, I was told the increase was due to the change in the catastrophic cover in 2024. Here is how I understand the statement by the United Healthcare/AARP agent. In order to protect the drug manufacturer’s profits, the PBMs take, and UHC’s portion; the Part D increase is increased to all the people who have Part D coverage. The woman who told me this was surprised I did not get angry. Maybe, I did not get angry because I understand the game being played here.

Just a bit more from KFF and I am done.

Monthly premiums for drug coverage are substantially higher for PDPs compared to MA-PDs. On average, pricing is five times higher in 2024 (based on unweighted amounts). As stated, the average premium will increase between 2023 and 2024 for PDPs. Pricing is expected to remain stable (and low, or even zero) for MA-PDs. MA-PD sponsors can use CMS rebate dollars from Medicare payments to lower or eliminate their Part D premiums. There is no equivalent rebate system for PDPs. Without CMS rebates, MA plans would lose profitability.

Average monthly premiums for the 14 national PDPs (Medicare FFS) are projected to range from under $1 to $108 in 2024. Premium variation across the plans is in part related to whether plans offer basic or enhanced benefits plus the value of benefits offered. Included are the variation in the underlying costs the plans incur for their enrollees. Among the national PDPs, average monthly premiums are increasing for 12 PDPs. This includes 4 PDPs with increases greater than $20 and 3 with increases between $10 and $20.

There are a couple of Part D plans which did not have the same increase. I am going to check on them an let you know why and probably switch to them.

Other Information

CMS Releases 2024 Projected Medicare Part D Premium and Bid Information, CMS.

Medicare Advantage in 2023: Premiums, Out-of-Pocket Limits, Cost Sharing, Supplemental Benefits, Prior Authorization, and Star Ratings, KFF