Dropping Part D Bids May Mean Plan Underpayment in 2021

August 6

In its annual release of Medicare Part D payment benchmarks and other bid-related information for the coming plan year, CMS on July 29 reported that the average monthly premium for basic Part D coverage will increase just 50 cents in 2021, while the national average monthly bid amount will continue its downward trajectory, dropping nearly 10% to $43.07.

Tom Kornfield, senior consultant with Avalere Health, explains that relative to prior yearly changes, the reinsurance subsidy — which funds 80% of all Part D costs for beneficiary expenses above the catastrophic threshold — went up more than the bid amount went down. “Essentially what we’re seeing is, plans had been projecting relatively flat or very small increases in the reinsurance, but for next year [CMS] projected a 7% increase in the reinsurance amount,” he says.

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Radar on Medicare Advantage

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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