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Some Medicare drug costs to jump by double digits next year

CNBC logo CNBC 9/29/2015 Dan Mangan

Seniors, get ready to dig deeper into your wallets, or to start shopping more.

More than 15 million people enrolled in the top 10 Medicare "Part D" prescription drug plans will face average premium hikes of 8 percent next year, according to a new analysis. Those top 10 plans account for more than 80 percent of enrollment in such drug plans, the Avalere Health consultancy found.

Five of the top prescription drug plans will see double-digit premium hikes next year.

Avalere also found that the average prescription drug plan premium in 2016 will top $40 per month for the first time in the federally subsidized program's history. If all Part D enrollees stay in their current plan, the average premium for all prescription drug plan would rise from $38.83 per month this year to $41.34 per month in 2016.

The findings come as rising prescription drug costs have drawn renewed attention from Congress and Democratic presidential candidates, including Hillary Clinton and Sen. Bernie Sanders. Trustees in the Medicare program said that in 2014, there was a 14 percent overall increase in the cost of Part D benefits, and a per-capita increase of 11 percent. The trustees singled out the very high prices of new specialty medication, including for hepatitis C, as a driving factor in the cost increases to Medicare.

Avalere said there will be drop in the number of Medicare Advantage plans that offer enrollees a $0 deductible for their prescription drug benefits, meaning there were be fewer options for customers looking for limit their out-of-pocket health costs.

But Medicare Advantage premiums overall are set to drop slightly for 2016, by 1 percent on average, Avalare said. The average monthly premium for the increasingly popular Medicare Advantage plans, which are privately run but federally subsidized, will be $32.60 per month.

Avalere also found that 81 percent of the nearly 17 million Medicare Advantage beneficiaries will have an option of enrolling in a plan with a $0 monthly premium, compared with 78 percent of those beneficiaries in 2015.

© David Paul Morris/Bloomberg   

Most Medicare Advantage plans include a prescription drug benefit. People in traditional Medicare must separately shop for and enroll in a Part D plan to cover their medications.

The overall trend of higher average prices for Part D plans, and the shrinking number of options for $0 deductibles within the Medicare Advantage market, are yet more evidence that Medicare beneficiaries should be actively looking around to see if they can find better deals, said Colin Shannon, senior manager at Avalere.

"You've got to shop," Shannon said.

"Medicare beneficiaries should carefully review their prescription drug plan options in 2016 to make sure they choose a plan that is right for them," said Shannon. "With many plans taking large premium increases in 2016, those beneficiaries that choose not to change plans will likely pay more in premiums than if they look for lower-cost options."

But if the past is any guide, most seniors will stay put in their current plans when open enrollment begins Oct. 15, despite the opportunity for a better deal, and despite that many Medicare beneficiaries are on fixed incomes.

Shannon noted that Kaiser Family Foundation research has found that only about 13 percent of Medicare beneficiaries change plans from year-to-year. He said that the difficulty of researching the plan options, and then balancing their respective costs and benefits before making a decision to switch, can be a challenge for seniors.

"It's hard, there's no question about it," Shannon said.


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