June 14, 2009

New Medicare Part D Parameters for 2010

The final 2010 Medicare Part D Defined Standard Benefit parameters are now available online at Q1Medicare.com. The website highlights how the Medicare Part D plans have changed over the past several years, including a comparison of the Medicare Part D Defined Standard Benefits from 2006 through 2010.

The final 2010 Part D Defined Standard Benefit parameters increased slightly from the preliminary figures that were released in late February. Medicare beneficiaries who enroll in a 2010 Medicare Part D prescription drug plan modeled after the CMS Defined Standard Benefit can expect a 4.66% increase in their 2010 Medicare Part D prescription drug plan costs, such as their initial deductible and Donut Hole limits.

Q1Medicare.com has also updated its 2010 PDP-Planner to help the Medicare community better understand how these 2010 changes will affect next year’s prescription drug spending. Although in practice, most Part D plan designs deviate from the CMS Defined Standard Benefit, the 2010 parameters offer some insight into what can be expected from 2010 prescription drug plans.

We designed our PDP-Planner to let users enter estimated retail prescription costs based on their current drug spending–and have the flexibility to change Medicare Part D plan parameters values, such as the initial deductible–to get an idea of how they will move through the phases of their Part D plan. We also provide a PDP-Planner example for people who are just getting started.

The Centers for Medicare and Medicaid Services (CMS) publish the Part D Defined Standard Benefit parameters each year and originally released the preliminary 2010 parameters for the Defined Standard Benefit in February showing a projected 3.13% increase over the 2009 Part D plan parameters. In the final version, CMS updated the parameters to represent an increase of 4.66% over the 2009 values. The parameters include such Part D plan variables as the initial deductible, as well as the Initial Coverage Limit and the Out-of-Pocket Threshold, which together form the boundaries of the Donut Hole or Coverage Gap.

Medicare beneficiaries who decide to enroll in a 2010 Part D prescription drug plan will see their 2010 initial annual deductible increase to $310 from the current 2009 value of $295. Medicare beneficiaries will also enter the 2010 Donut Hole a little later when their total retail drug costs reach $2,830, as compared to this year’s 2009 Initial Coverage Limit of $2,700. On the downside, 2010 Medicare Part D beneficiaries will exit the Donut Hole when they personally spend over $4,550 out of pocket on prescription drugs. The current 2009 Out-of-Pocket threshold is $4,350.

PDP-Planner is available on Q1Medicare.com along with other online tools, a section of Frequently Asked Questions, a free monthly Medicare Part D Newsletter and tutorials all designed to help Medicare beneficiaries, advocates, advisors, and insurance agents navigate the Medicare prescription drug program.

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