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Part D Insurance
Humana Part D

Licensed Medicare Part D agents represent virtually every insurer in the United States. No one knows the rules and regulations of the Medicare industry better than the local insurance agent.

Medicare Insurance Plans

Expected Changes in Medicare Part D for 2013?

Medicare Part D Plan in 2013?

Based on cost and benefit data from the Centers for Medicare and Medicaid Services (CMS)

What changes can you expect for next year?

In general, most of next year's 2013 Part D standard plan benefit parameters are based on an increase of 7.5% over the same 2012 parameters. In other words, plan variables like the initial deductible or doughnut hole limits will increase by around 7.5%.

Please note that these parameters do not include information on the average monthly Part D plan premium.

Key 2013 Part D plan parameters affected by this increase include:

1. the initial annual deductible - increasing from $290 in 2012 to $325 in 2013 (please note that some, if not most, 2013 Medicare Part D plans do not have an initial deductible and provide first dollar coverage),

Medicare Part D Coverage

2. the initial coverage limit - also know as the portion of coverage shared by the beneficiary and the insurance carrier before the doughnut hole or coverage gap, increases from $2,700 to $2,970,

3. the annual out-of-pocket threshold - or the total amount that beneficiaries could personally spend before exiting the doughnut hole is increasing from $4,325 to $4,750.

4. the Retiree Drug Subsidy (RDS) cost threshold and cost limit for 2013 qualified retiree prescription drug plans will increase by 7.5% from their current 2012 values of $290 and $6,050 to $312 and $6,504 respectively.

How will changes in 2013 compare to the changes we experienced in 2012?

The 7.5% increase in 2013 Part D plan values can be compared to a 4.6% increase in Part D plan parameters from 2012.

What do all these numbers mean?

Your Medicare Part D plan will change each year. Each year CMS releases a Defined Standard Benefit or standard Medicare Part D plan as a model for the next year's Medicare Part D plans.

As an example, next year if you have a Medicare Part D plan that exactly follows this 2013 CMS plan, you will notice an increase in your initial deductible to $325 from the current 2012 value of $290. Those with substantial drug bills can expect an increase in their true out of pocket expenses while in the donut hole, prior to their reaching the catastrophic coverage threshold of their Medicare D policy. The 2013 out of pocket threshold currently stands at $4,750.

Some 2013 Medicare Part D plans may be exactly the same as the standard CMS plan. Other 2013 Medicare Part D plans may provide some doughnut hole (or coverage gap) coverage and/or no initial deductible or even a variation of the initial deductible.

We will help you get an idea of your potential 2013 prescription drug expenses.

Please take note: "It is not possible for MA plan enrollees to simultaneously enroll in a PDP plan, unless they are subscribing to a Medicare MSA policy or a PFFS policy which does not provide coverage for prescription drugs. If this is the case, these individuals may enroll in a PDP plan irrespective of whether the same provider offers a PFFS policy that provides prescription drug coverage. " Chapter 2 " Medicare Advantage Enrollment and Disenrollment" of the CMS Medicare Managed Care Manual, Section 20 (2013).

We notedthat enrollment in a stand-alone prescription drug plan (PDP) may affect the status of your current Medicare Advantage plan.

We caution that enrollment in a Medicare Advantage plan without prescription coverage may indicate to CMS that you no longer wish to have Medicare Part D coverage for the current year. It's important that you understand your options before enrolling in any Medicare health plan and consult a professional for assistance regarding Medicare rules and regulations.

jm-598-45-12172012