The Medicare Drug Benefit in California: Facts and Figures
Avalere Health, LLC
November 2008
This presentation examines the key elements of the Medicare Part D drug benefit to provide a portrait of the program's implementation in California.
The analysis describes several important changes in plan choices, enrollment, premiums, and cost sharing for beneficiaries in 2009, including:
- Medicare beneficiaries in California will continue to have a wide range of plan options that vary by county. While the overall number of options will remain largely the same in 2009, low-income beneficiaries will have fewer choices of plans in which premiums are fully subsidized -- down from nine plans in 2008 to six in 2009.
- Many Part D plans have raised their monthly premiums above 2008 levels. More than 80% of Medicare beneficiaries in California with standalone prescription drug plans (PDPs) will likely see monthly premiums increase more than $5 in 2009 if they remain in their current plan. By contrast, 94% of Medicare Advantage prescription drug plan enrollees will see no change or a decrease in premiums.
- Beneficiaries whose income or assets are just above the limit for the low-income subsidy (LIS) are likely to face relatively high out-of-pocket costs for their prescriptions.
- Nationally, over one-fifth of low-income beneficiaries who are eligible for the LIS are not enrolled in this benefit, suggesting a need for expanded outreach efforts.
The complete presentation is available under Document Downloads below.