Next year there will be a total of 1,109 prescription drug plans (PDPs) offered nationwide, down nearly one third from 1,576 in 2010. The reduction can be attributed to recent regulations issued by the Centers for Medicare & Medicaid Services, which sought to eliminate duplicative plan offerings and plans with low enrollment. At the peak in 2007, there were 1,875 PDPs.
The analysis comes in a Henry J. Kaiser Family Foundation report, “Part D Plan Availability in 2011 and Key Changes Since 2006.” It says that 9 of the 16 national plan sponsors will drop at least one of their 2010 PDP offerings, in some cases because of mergers of plan sponsors.
If a beneficiary finds that his PDP has been dropped, he will be transferred automatically to one of the remaining PDPs offered by that sponsor.
Members also retain the right to select a different PDP during the open enrollment period.
More than 28 million people are enrolled in Part D plans, about 60 percent of them in PDPs, with the remainder enrolled in Medicare Advantage plans, which cover both medical services and prescription drugs. The number of PDPs per region in 2011 will range from 28 in Hawaii to 38 in Pennsylvania/ West Virginia.
In 2010, there were 41 in Hawaii and Alaska and 55 in Pennsylvania and in West Virginia, taken together.
| Change in plan offerings by top national plan sponsors | |||
|---|---|---|---|
| PDP sponsor | PDPs dropped | PDPs added | 2011 PDP offerings |
| UnitedHealth Group | •• | 0 | 2 national |
| Universal American | ••• | 0 | 2 national |
| Humana | ••• | • | 2 national; one more in 27 regions |
| Coventry Health Care | ••• | 0 | 2 national |
| CVS Caremark | •• | 0 | 3 national |
| WellPoint | 0 | 0 | 1 to 3 in each of 34 regions |
| WellCare Health Plans | 0 | 0 | 2 near-national in 33 regions |
| Medco Health Solutions | • | 0 | 2 national |
| Aetna | 0 | 0 | 3 national |
| Cigna | • | 0 | 2 national |
Source for both charts: Georgetown/NORC analysis of CMS PDP landscape, 2006-2011
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Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweißen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.