Plans expand 2007 drug benefit options

November 1, 2006

Washington, D.C.-The anticipated shakeout in Part D plans is not occurring this year. In fact, insurers and pharmacy benefit managers (PBMs) are offering more drug coverage options at lower costs for seniors.

WASHINGTON, D.C.-The anticipated shakeout in Part D plans is not occurring this year. In fact, insurers and pharmacy benefit managers (PBMs) are offering more drug coverage options at lower costs for seniors. Due to "robust competition," plans are expanding drug coverage, dropping less popular options and providing more plans with enhanced coverage, said Mark McClellan, MD, then administrator of the Centers for Medicare & Medicaid Services (CMS), in announcing Part D options in September. Few beneficiaries will have to change plans because most Part D sponsors are continuing current programs for 2007 or streamlining and consolidating existing plans.

Monthly premiums for stand-alone prescription drug plans (PDPs) in 2007 will average $24 a month with a median cost of $33, according to CMS. Competition evidently drove down some higher priced plans, while also boosting the lowest premiums (the lowest-cost PDP will be $9.50 instead of $1.87).

Other key developments include:

CMS emphasizes that seniors who are satisfied with their current plan do not have to take any action. But consumer health experts note that existing plans may change formularies as well as premiums and copays and that beneficiaries should take a fresh look at all available options.