During the 2024 Medicare Annual Election Period that starts on Oct. 15, a total of 708 stand-alone Prescription Drug Plans will be available for beneficiaries in 2024 nationwide, a 12% drop from 2023. Only 126 PDPs will be offered without a premium to enrollees receiving the Low-Income Subsidy (LIS) in 2024, compared with 191 PDPs in 2023.
A few national insurers have dominated the PDP market for years. In 2024, PDP premiums among the 14 national plans will range from $107.93 for Humana Premier Rx Plan to 74 cents for Wellcare Value Script, according to AIS Health’s analysis of CMS Medicare Advantage and Part D files.
A recent Avalere analysis estimated that PDP bids more than doubled in 2024 and the average PDP premium increased by 21% from 2023 to 2024. Over 8 million enrollees in standalone PDPs may see a premium increase of more than 25% if they stay in the same plans.
Meanwhile, about 2 million LIS benchmark plans’ enrollees may have to switch to other LIS benchmark plans, as their current plans won’t qualify as benchmark plans in 2024. In 10 states, more than 60% of LIS enrollees may need to leave their current plan or pay a premium, with Florida topping the list (79%).
Beginning in 2024, under a provision in the Inflation Reduction Act, the 5% coinsurance requirement for Part D enrollees without LIS that applies in the catastrophic phase of coverage will be eliminated and health plans will pay 20% of total drug costs in that phase. The catastrophic threshold will be set at $8,000. A KFF analysis showed that for the top five high-cost, commonly used cancer drugs — Revlimid, Pomalyst, Imbruvica, Jakafi and Ibrance — annual out-of-pocket costs per drug in 2023 ranged from over $11,000 to nearly $15,000, and out-of-pocket costs for each drug in the catastrophic phase ranged from $8,000 to nearly $12,000. The catastrophic coverage change will help enrollees without LIS save thousands of dollars in 2024.
This infographic was reprinted from AIS Health’s biweekly publication Radar on Drug Benefits.