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The Medicare Drug Benefit: Changes in California for 2007

Avalere Health, LLC

This fact sheet provides a first look at changes to Medicare Part D offerings in California for 2007. It examines changes in the number of participating plans, benefits, premiums and cost sharing.

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November 2006

Open enrollment for the Medicare Part D prescription drug benefit ran from November 15 through December 31, 2006, and provided an opportunity for Medicare beneficiaries to enroll or change plans.

This CHCF fact sheet, published in November, 2006, highlights several important changes to the drug benefit and the options available to Medicare beneficiaries in California for 2007. It examines changes in the number of participating plans, benefits, premiums, and cost sharing.

Key findings include:

  • The number of participating Part D plans in California will rise from 157 in 2006 to 200 in 2007. Much of this increase is attributable to a growing number of Medicare Advantage health plans with drug coverage.
  • Most beneficiaries in stand-alone drug plans must switch plans to take advantage of lower median premiums for both stand-alone drug plans and Medicare Advantage drug plans in 2007.
  • More plans are offering coverage for generic drugs in the "doughnut hole" (the gap between the initial coverage limit and the catastrophic coverage threshold).
  • The average copayment for many generic drugs is falling, while many other benefit features are changing only slightly.
  • Due to changes in federal policy, Medicare beneficiaries eligible for the full federal subsidy can choose from 14 stand-alone plans without paying a premium. The number of Medicare Advantage plans available to full subsidy beneficiaries at no premium varies by county.

The complete fact sheet is available under Document Downloads.