Selection and cost savings of Part D plans by Medicare beneficiaries

Background: Medicare beneficiaries have the opportunity to switch their Part D prescription drug plan during the Annual Election Period (AEP). The selection process can be overwhelming for most beneficiaries considering the number of available plans and each plan's unique cost-sharing structure and formulary. We examined how California beneficiaries chose their current stand-alone prescription drug plan (PDP), the factors that influenced PDP switching, and the cost savings of switching PDPs during the 2011 AEP. Methods: Nine outreach events were held in cities across Central/Northern California during which 397 beneficiaries were assisted with their Part D plan, 269 of whom were enrolled in a PDP in 2010. Beneficiary demographic data and plan choice rationale were collected by a survey. The Medicare website was used to calculate the estimated annual cost of 2010 and 2011 PDPs. Results: Of the 269 beneficiaries enrolled in a PDP, 107 (40%) received enrollment assistance through a similar outreach event the previous year, 29 (11%) enrolled through an insurance broker, and 23 (9%) were automatically enrolled. Only 16 (6%) beneficiaries contacted Medicare or used the Medicare website for enrollment assistance. Estimated plan cost was the primary factor switching PDPs. Beneficiary's 2010 PDP was the lowest cost plan in 2011 for only 62 (23%) individuals with a mean (SD) annual cost of $1,352 ($1,324), and was significantly more expensive than the lowest cost 2011 PDP ($900 [$1,044]; p<0.001). Conclusions: Plan cost significantly influenced PDP switching in beneficiaries and resulted in significant potential cost savings.