InfoStat | 09-22-2015

More $0 Premiums for Medicare Advantage in 2016

Drug deductibles 25 percent higher for Medicare Advantage and 38 percent higher for Medicare Part D




Every year between October 15 and December 7, Medicare beneficiaries can change their Medicare health plans and prescription drug coverage to better align with their personal needs. Since plans may change their costs and coverage every year, the least expensive plan options for Medicare beneficiaries may also change from year to year.

Yesterday the federal government released data on 2016 Medicare Advantage and Prescription Drug Plans. HealthPocket analyzed this data to determine how costs compared to 2015 Medicare plans, and to find the highest and lowest premiums by state.

The average premium across all Medicare Advantage health insurance plans for 2016 is $64.92. This is 4 percent higher than the 2015 average premium of $62.69. This amount is also 99 percent higher than the average of $32.60 that the government reported since the government weighted the average by projected plan enrollment rather than averaging across all premiums available in the market.

The least expensive Medicare Advantage plan is still $0. However, the number of $0 Medicare Advantage premiums has increased 6 percent since 2015 after dropping 19 percent from 2014 to 2015. The most expensive Medicare Advantage plan, at $388 a month, is the EmblemHealth VIP High Option plan in the state of New York. In 2015, the most expensive Medicare Advantage plan was the HealthPartners Freedom Ultimate with Enhanced Rx in the state of Minnesota. It cost $347.10 per month, 11 percent lower than the highest premium in 2016.

2016 Medicare Advantage premiums by state

StateAverage premiumNumber of $0 premiumsLowest premiumHighest premium
Alabama$51.88216$0.00$188.00
Arizona$55.0153$0.00$188.00
Arkansas$44.49164$0.00$188.00
California$29.85176$0.00$221.00
Colorado$89.52100$0.00$300.00
Connecticut$71.0635$0.00$240.00
Delaware$66.185$0.00$188.00
Florida$26.88673$0.00$188.00
Georgia$41.04367$0.00$188.00
Hawaii$96.406$0.00$202.00
Idaho$87.0020$0.00$302.50
Illinois$65.37215$0.00$188.00
Indiana$48.04280$0.00$188.00
Iowa$27.68334$0.00$187.60
Kansas$62.52145$0.00$190.00
Kentucky$56.36254$0.00$188.00
Louisiana$41.98234$0.00$185.00
Maine$46.9964$0.00$188.00
Maryland$49.1731$0.00$190.00
Massachusetts$85.5641$0.00$244.00
Michigan$93.16257$0.00$294.00
Minnesota$111.6282$0.00$354.10
Mississippi$38.56145$0.00$97.00
Missouri$43.15272$0.00$188.00
Montana$51.954$0.00$97.00
Nebraska$49.7447$0.00$188.00
Nevada$54.2020$0.00$203.00
New Hampshire$48.670$20.00$89.00
New Jersey$75.1864$0.00$190.00
New Mexico$73.7173$0.00$166.60
New York$56.32516$0.00$388.00
North Carolina$41.07352$0.00$188.00
North Dakota$140.729$0.00$229.00
Ohio$65.54527$0.00$188.00
Oklahoma$48.49262$0.00$188.00
Oregon$75.2867$0.00$242.00
Pennsylvania$78.63371$0.00$299.50
Rhode Island$57.0920$0.00$247.00
South Carolina$41.5180$0.00$80.00
South Dakota$125.7251$0.00$229.00
Tennessee$46.02656$0.00$218.00
Texas$61.24698$0.00$286.50
Utah$28.6353$0.00$235.00
Vermont$58.664$0.00$151.00
Virginia$50.74232$0.00$190.00
Washington$84.5039$0.00$273.00
Washington D.C.$52.583$0.00$188.00
West Virginia$59.75156$0.00$212.50
Wisconsin$91.64156$0.00$275.00
Wyoming$36.200$23.00$50.00
USA$64.928629$0.00$388.00

The average drug deductible for 2016 Medicare Advantage plans with drug coverage (MA-PD plans) is $162.67. This is 25 percent higher than the 2015 average deductible of $129.87. The maximum allowable MA-PD drug deductible in 2016 is $360, $40 higher than the maximum allowable deductible of $320 for 2015 MA-PD plans.

2016 MA-PD premiums and drug deductibles by state

StateAverage premiumLowest premiumHighest premiumAverage drug deductible
Alabama$67.91$0.00$188.00$200.55
Arizona$67.18$0.00$188.00$124.09
Arkansas$59.78$0.00$188.00$196.51
California$29.62$0.00$221.00$113.31
Colorado$123.15$0.00$300.00$161.12
Connecticut$81.78$0.00$240.00$80.19
Delaware$66.18$0.00$188.00$162.35
Florida$32.75$0.00$188.00$131.19
Georgia$48.44$0.00$188.00$209.32
Hawaii$100.42$0.00$202.00$101.88
Idaho$121.22$0.00$302.50$129.97
Illinois$80.85$0.00$188.00$230.79
Indiana$60.09$0.00$188.00$141.14
Iowa$28.05$0.00$187.60$218.21
Kansas$102.02$0.00$190.00$245.28
Kentucky$65.84$0.00$188.00$225.30
Louisiana$48.57$0.00$185.00$222.77
Maine$60.41$0.00$188.00$63.52
Maryland$51.14$0.00$190.00$127.17
Massachusetts$87.29$0.00$244.00$182.45
Michigan$103.55$0.00$294.00$175.65
Minnesota$133.65$27.50$354.10$218.03
Mississippi$57.38$0.00$97.00$291.59
Missouri$53.70$0.00$188.00$170.77
Montana$54.64$9.00$97.00$126.62
Nebraska$59.77$0.00$188.00$226.64
Nevada$61.94$0.00$203.00$62.62
New Hampshire$50.68$20.00$89.00$176.27
New Jersey$85.63$0.00$190.00$181.15
New Mexico$82.90$0.00$166.60$58.48
New York$65.87$0.00$388.00$113.01
North Carolina$53.83$0.00$188.00$184.00
North Dakota$144.54$71.00$229.00$184.17
Ohio$74.79$0.00$188.00$118.80
Oklahoma$65.86$0.00$188.00$128.29
Oregon$94.01$0.00$242.00$116.87
Pennsylvania$89.63$0.00$299.50$58.41
Rhode Island$69.78$0.00$247.00$157.78
South Carolina$52.74$0.00$80.00$216.00
South Dakota$133.68$0.00$229.00$196.34
Tennessee$56.74$0.00$218.00$81.32
Texas$70.66$0.00$286.50$151.74
Utah$31.96$0.00$235.00$125.83
Vermont$63.75$0.00$151.00$217.14
Virginia$65.01$0.00$190.00$237.79
Washington$91.89$0.00$273.00$167.66
Washington D.C.$59.00$0.00$188.00$135.56
West Virginia$76.42$0.00$212.50$146.43
Wisconsin$103.06$0.00$275.00$242.06
Wyoming$47.75$32.00$50.00$258.13
USA$76.67$0.00$388.00$162.67

United States for 2016 is $52.68. This is 2 percent lower than the 2015 average premium of $53.90. This amount is also 62 percent higher than the average of $32.50 that the government reported since the government weighted the 2016 premium average by anticipated plan enrollment rather than averaging across all Part D plan premiums available in the market.

The least expensive Medicare Part D plan in 2016, at $11.40 per month, is the SilverScript Choice plan in the state of Arkansas. In 2015, the least expensive Medicare drug plan was the SilverScript Choice plan in New Mexico. It cost $12.60 per month, 11 percent higher than the least expensive plan in 2016. The most expensive 2016 Medicare Part D plan, at $174.70 a month, is the BlueMedicare Rx-Option 2 plan in the state of Florida. In 2015, the most expensive Medicare Part D plan was also the BlueMedicare Rx-Option 2 in the state of Florida. It cost $171.90 per month, 2 percent lower than in 2016.

The average deductible for 2016 Medicare Part D drug plans is $217.37. This amount is 38 percent higher than the 2015 average deductible of $157.91. As is the case for 2016 Medicare Advantage plans, the maximum allowable Medicare Part D deductible in 2016 is $360.

2016 Medicare Part D premiums and deductibles by state

StateAverage premiumLowest premiumHighest premiumAverage drug deductible
Alabama $49.75$18.40$117.20$228.75
Alaska$49.30$18.40$89.20$245.00
Arizona$48.52$18.40$109.70$223.04
Arkansas$44.60$11.40$131.90$231.60
California$61.78$18.40$132.00$205.20
Colorado$59.01$18.40$140.20$213.75
Connecticut$50.98$18.40$127.60$205.43
Delaware$46.22$18.40$87.10$227.14
Florida$66.47$18.40$174.70$202.11
Georgia$52.74$18.40$135.50$213.75
Hawaii$40.82$18.40$80.10$213.16
Idaho$62.05$18.40$162.10$223.08
Illinois$53.72$18.40$157.40$234.00
Indiana$54.97$18.40$130.20$219.60
Iowa$52.12$18.40$124.20$223.04
Kansas$55.21$18.40$125.20$207.39
Kentucky$54.97$18.40$130.20$219.60
Louisiana$46.65$16.80$106.10$233.18
Maine$49.88$18.40$119.30$205.20
Maryland$46.22$18.40$87.10$227.14
Massachusetts$50.98$18.40$127.60$205.43
Michigan$52.04$18.40$117.50$219.60
Minnesota$52.12$18.40$124.20$223.04
Mississippi$45.81$17.30$119.20$227.14
Missouri$52.90$18.40$124.10$219.60
Montana$52.12$18.40$124.20$223.04
Nebraska$52.12$18.40$124.20$223.04
Nevada$58.37$18.40$134.40$205.20
New Hampshire$49.88$18.40$119.30$205.20
New Jersey$54.85$18.40$104.70$216.82
New Mexico$45.14$12.00$152.70$228.75
New York$50.42$18.40$93.40$221.58
North Carolina$51.31$18.40$120.50$217.17
North Dakota$52.12$18.40$124.20$223.04
Ohio$54.88$18.40$128.00$213.75
Oklahoma$53.36$18.40$163.80$228.75
Oregon$53.09$18.40$154.20$211.25
Pennsylvania$59.06$18.40$149.60$197.31
Rhode Island$50.98$18.40$127.60$205.43
South Carolina$49.82$18.40$124.40$198.75
South Dakota$52.12$18.40$124.20$223.04
Tennessee$49.75$18.40$117.20$228.75
Texas$52.82$18.40$163.00$234.00
Utah$62.05$18.40$162.10$223.08
Vermont$50.98$18.40$127.60$205.43
Virginia$51.52$18.40$124.50$205.20
Washington$53.09$18.40$154.20$211.25
Washington D.C.$46.22$18.40$87.10$227.14
West Virginia$59.06$18.40$149.60$197.31
Wisconsin$61.40$18.40$139.40$205.20
Wyoming$52.12$18.40$124.20$223.04
USA$52.68$11.40$174.70$217.37

The maximum possible cap on out-of-pocket costs for covered drug expenses in 2016 is $4,850 for both Part D and Medicare Advantage plans. This limit is $150 higher than the 2015 limit of $4,700. After this out-of-pocket threshold is reached, the beneficiary will be provided ‘catastrophic coverage’ with lower drug cost-sharing.

Conclusion

There are 6 percent more $0 Medicare Advantage premiums in 2016, after the number of $0 Medicare Advantage premiums dropped 19 percent from 2014 to 2015. However, average Medicare Advantage premiums in 2016 are up 4 percent from 2015.

Despite the higher number of $0 premiums for Medicare Advantage plans, drug deductible costs for MA-PD plans and Part D plans will increase substantially in 2016. Part D deductibles will be 38 percent higher in 2016, while MA-PD deductibles will be 25 percent higher. The maximum possible drug deductible for Medicare plans is also increasing from $320 in 2015 to $360 in 2016.

Given the changes in costs and coverage for 2016 Medicare health and drug plans, Medicare beneficiaries should carefully review the plans that are available to them in 2016 to determine whether they should keep their current plans or switch to a plan that better aligns with their personal needs. Initial information on 2016 Medicare Part D and Medicare Advantage plans can be reviewed within the Medicare Plan Comparison Tool at HealthPocket.com.

Methodology

Premiums and deductibles for Medicare health and drug plans were obtained from the 2016 MA and PDP landscape source files available at cms.gov on September 21, 2015. Alaska was not included in the Medicare Advantage data.

Sanctioned plans were not included in the analysis. No adjustment was made for market share of each plan. All analysis assumes the accuracy of the underlying government data.


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AUTHOR

Jesse Geneson, data scientist at HealthPocket.com, authored this analysis. Correspondence regarding this study can be directed to jesse.geneson@healthpocket.com.

Jesse Geneson on Google+

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