It’s once again time for Medicare participants to consider changes to their healthcare plans. The annual open enrollment period for Medicare Advantage and “Part D” prescription plans is now underway.
Also fast approaching is the open enrollment period for Marketplace insurance coverage under the federal Affordable Care Act (ACA), which is also commonly known as Obamacare.
Although both programs are federal, state legislators often receive questions during the enrollment periods and work to link constituents with the appropriate program administrators.
There is some good news for Illinois residents participating in the Part D prescription drug benefit – average premiums are lower than surrounding states and the number of plans to choose from is higher than any other state in the nation.
Medicare-eligible persons have until Dec. 7 to enroll or modify their drug benefit (Part D) coverage or their Medicare Advantage plan – which offers an alternative to regular Medicare coverage through Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs).
Persons receiving health insurance under an Affordable Care Act (ACA) Marketplace Plan must either renew their coverage or choose a new plan during the open enrollment period which runs from Nov. 15 to Feb. 15. Those who fail to enroll in health insurance by the end of the ACA enrollment period face an increased penalty next year – the higher of 2% of income, or $325 per adult and $162.50 per child.
In conjunction with the Medicare open enrollment period, the Kaiser Family Foundation has issued two reports analyzing key market changes in Medicare Advantage and Medicare Part D prescription drug programs.
Both studies show slight declines in the number of plans available. For Medicare Part D, there are expected to be 1,001 prescription drug plans available nationwide, the lowest number since Part D began in 2006. The average premium is expected to increase by 4%, from $37.27 monthly to $38.83. Average premiums have increased by 50% since 2006.
However, that average is deceptive, as there are wide variations in individual plans. The Kaiser report indicates that six of the 10 most popular plans will see double-digit premium increases, while three of the 10 most popular will see double-digit decreases.
Although Illinois will see the highest premium increase in the nation – 9.4%. – its average premium of $35.99 will still be lower than any surrounding state and lower than the U.S. average. Across the Midwest and Great Plains, only Ohio has a lower average premium of $34.94.
Kentucky and Indiana will see increases of just 1.6%, while Missouri’s increase will be 2.4%. But the average premium in all three states remains higher than Illinois.
There will be five fewer prescription drug plans available in Illinois in 2015, as compared to 2014. The number of plans available in Illinois peaked in 2007 at 56. Still, the 33 plans available to Illinois residents in 2015 will be the most available in any state.
In the case of Medicare Advantage, the Kaiser study says the number of available plans is likely to shrink by 3%, but that will still leave 1,945 plans available in 2015. The study estimates that 3% of enrollees nationwide will be affected by plans leaving the marketplace and will need to find an alternative, either another Medicare Advantage plan or traditional Medicare.
In Illinois, the number of available plans will actually go up. In 2014, there were 66 plans available. Of that total, 15 are expected to leave the state, but another 17 will enter the Illinois market. The study predicts that just 1% or 2,218 enrollees will need to find new plans.
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