Part D Standard Benefit Model Changes for 2015 detailed
The Part D Standard Benefit Model is a set of guidelines from the Centers for Medicare and Medicaid Services (CMS) that are applied to all Part D plans. The 2015 Medicare Part D changes are detailed below.
You will pay a higher deductible amount in 2015 (if required) and will spend more be in the donut hole if you are unfortunate enough to reach it.
A recent CMS news release indicates that Part D premiums will increase by an average of $1 in 2015. Part D premiums for 2015 plans will average about $32 per month.
Co-branding of plans with major retail chains and discounts for using preferred pharmacies will continue to be a popular trend.
Standard Benefit Model Costs for 2015 plans
- The deductible will increase from $310 to $320 (not all plans require a deductible)
- Initial coverage limit will be increased from $2850 to $2960
- The out-of-pocket threshold will increase from $4550 in 2014 to $4700
- Donut hole (coverage gap) begins when you reach the $2960 coverage limit and ends when you have spent $4700
- Cost-sharing in the catastrophic portion will increase to the greater of 5% or $2.65 for generics and the greater of 5% or $6.60 for brand-name drugs
If you reach the donut hole you will receive a 55% discount on name brand drugs and pay a maximum of 65% on generic drugs.
You should look for your Annual Notice of Change and Evidence of Coverage document to detail any changes to your specific plan. This document must be mailed by September 30th.
5 things you should know about Medicare Part d before you enroll in a plan