Responding to inquiries from Reuters, Humana and AARP both issued statements acknowledging rising drug costs as key factors driving premium increases, along with consumer usage patterns.
A report released early this year by the Medicare Payment Advisory Commission (MedPAC), which monitors Medicare for Congress, states that the trend will pose a “big challenge” for the Part D program in the years ahead, as fewer big blockbuster drugs are going generic and more than half of new drug approvals are for specialty drugs.
Huge increases in the prices of some older drugs have sparked a political firestorm in recent weeks.
Along with premiums, Medicare shoppers should consider how well a plan matches your medication needs. Look carefully at the “formulary” in a plan to determine your prescriptions are covered, what cost-sharing is required and whether any special rules apply.
In some cases, the insurer can require you to start with an alternate medication rather than the drug your physician prescribes (step therapy), limits on quantity or a required prior authorization.
Plans increasingly are using preferred pharmacy networks to deliver drugs as a cost-control mechanism; that could be a big retailer such as Wal-Mart, CVS or Walgreen’s or a delivery-by-mail option. Whatever you decide, make sure you are comfortable with the delivery network for plans that you are considering.
The opinions expressed here are those of the author, a columnist for Reuters.