Learn about Medicare Part D plans

CMS finalizes 2016 payment and policy updates for Medicare Health and Drug Plans


April 6, 2015

Contact: CMS Media Relations

(202) 690-6145 | go.cms.gov/media

CMS finalizes 2016 payment and policy updates for Medicare Health and Drug Plans

Rate Announcement Details Plan Payments and Other Program Updates for 2016


The Centers for Medicare & Medicaid Services (CMS) today released final Medicare Advantage (MA) and Part D Prescription Drug program changes for 2016 that provide fair and accurate payments to plans, and encourage the delivery of high-quality care for all populations.


“These policies strengthen Medicare Advantage for current and future consumers by encouraging higher quality care,” said Andy Slavitt, acting CMS Administrator. “As the Medicare Advantage marketplace continues to grow, consumers are getting access to better care through more choice and competition. Seniors and people with disabilities, including the dual-eligible population, will continue to have an extensive choice of plans, affordable premiums, and better and more transparent information about provider networks and pharmacies.”


The Medicare Advantage and the Part D Prescription Drug programs’ enrollments and quality continue to grow and improve since the Affordable Care Act became law. Medicare Advantage has reached record high enrollment each year since 2010, a trend continuing in 2015 with a cumulative increase of more than 40 percent since 2010. At the same time, premiums have fallen by nearly 6 percent from 2010 to 2015. And, more than 90 percent of Medicare beneficiaries have access to a $0 premium Medicare Advantage plan.


The finalized policies fully consider the many comments received during the public comment period. Particular care is being taken to ensure that plan sponsors have the right incentives to care for dual eligible populations over the long term. The Rate Announcement finalizes changes in payments that will affect plans differently depending on the characteristics of those plans. On average, the expected revenue change is 1.25 percent without accounting for the expected growth in coding acuity that has typically added another 2 percent.  The final revenue increase is larger than the February advance notice largely because the Medicare actuaries recently updated Medicare per capita spending estimates for 2014 and 2015. Medicare per capita spending in 2014, 2015 and 2016 is still expected to be below historical standards.


Today’s announcement drives important improvements to the star rating system, additional accuracy and transparency of provider networks, and continues to promote improvements in quality of care for beneficiaries. The policies in the Rate Announcement and final Call Letter reflect Secretary Burwell’s commitment to a Medicare program – including Medicare Advantage – that delivers better care, spends health care dollars more wisely and results in healthier people. In the Final Call Letter, CMS continues to update the Star Ratings measures to drive improved quality for Medicare Advantage and Part D enrollees. To enhance program integrity and payment accuracy, Medicare Advantage plans will continue to be provided stringent oversight for improper payments, just like other providers in the Medicare program.


Lastly, the final policies will provide enrollees with greater information to make informed and timely decisions about their care and their coverage. The Final Call Letter takes steps to require Medicare Advantage plans to maintain accurate provider directories in a timely manner and make those directories widely available. These steps will help enrollees better understand the providers and choices available to them. In addition, CMS will ensure that Part D sponsors provide clear and accurate access to information on preferred cost sharing pharmacies in their networks so that all beneficiaries have access to affordable coverage.


To view a fact sheet on the 2016 Rate Announcement and final Call Letter, please visit: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-04-06.html

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Shared by: Robert Bache

Twitter @MedicareBob






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Medicare Prescription Drug Costs, 4 Ways to Lower Your Costs:

4 Ways to Help Lower Your
Medicare Prescription Drug Costs

Are you a person with Medicare who’s having trouble paying for prescription
drugs? Joining a Medicare Prescription Drug Plan may help, even if you have to
pay a late enrollment penalty.
There are other ways you may be able to save. Consider switching to drugs that
cost less. Ask your doctor if there are generic, over-the-counter, or
less-expensive brand-name drugs that could work just as well as the ones
you’re taking now. Switching to lower-cost drugs can save you hundreds or
possibly thousands of dollars a year.
You can also help lower your Medicare prescription drug costs by:
1. Exploring national and community-based programs that might offer
assistance (like the National Patient Advocate Foundation or the National
Organization for Rare Disorders) that may have programs that can help with
your drug costs. Get information on federal, state, and private assistance
programs in your area on the Benefits Check Up website, benefitscheckup.org.
The help you get from some of these programs may count toward your true
out-of-pocket (TrOOP) costs. TrOOP costs are the expenses that count toward
your Medicare drug plan out-of-pocket expenses—up to $4,750 for 2013.
These costs determine when your catastrophic coverage will begin.
2. Looking at State Pharmaceutical Assistance Programs (SPAP) to see if
you qualify. SPAPs in 22 states and 1 territory offer some type of coverage
to help people with Medicare with paying drug plan premiums and/or cost
sharing. Find out if your state has a State Pharmaceutical Assistance Program
at Medicare.gov/pharmaceutical-assistance-program/state-programs.aspx
or calling 1-800-MEDICARE. SPAP contributions may count toward your
TrOOP costs.

3. Looking into Manufacturer’s Pharmaceutical Assistance Programs
(sometimes called Patient Assistance Programs (PAPs)) offered
by the manufacturers of the drugs you take. Many of the major drug
manufacturers offer assistance programs for people enrolled in a
Medicare drug plan. Find out whether the manufacturers of the drugs
you take offer a Pharmaceutical Assistance Program by visiting
Medicare.gov/pap/index.asp or calling 1-800-MEDICARE
(1‑800‑633‑4227). TTY users should call 1-877-486-2048. Assistance
from PAPs isn’t part of Medicare Part D, so any help you get from this
type of program won’t count toward your TrOOP costs.
4. Applying for Extra Help paying for your Medicare prescription drugs.
If you have Medicare and have limited income and resources, you may
qualify for Extra Help paying for your prescription drugs. To apply for
Extra Help, contact Social Security at ssa.gov or by calling
1-800-772-1213. TTY users should call 1-800-325-0778.
If you need help finding resources, like the ones described above, call your
State Health Insurance Assistance Program (SHIP) for free personalized
counseling to people with Medicare. Get their phone number by visiting
Medicare.gov/contacts, or calling 1-800-MEDICARE.



Shared by:

Robert W. Bache aka “MedicareBob™”

President / Producer

Senior Healthcare Direct

Direct Toll Free: 1-800-525-0299

Company Toll Free: 1-855-368-4717


Incorrect Medicare Part D information may be on your letter from Social Security:

Senior Healthcare Direct
December 18, 2013
Incorrect Medicare Part D information may be on your letter from Social Security:

I hope you are doing well. This is Robert Bache, aka “MedicareBob™”. I want to share some information with you about a letter that you might receive from the Social Security Administration about an increase in your Social Security Income for 2014.

Great news: Most people are receiving an increase in their Social Security Income.

Bad news: Social Security did not communicate very well with Medicare regarding your Medicare Part D information. On this letter, the Part D information does not reflect if you made a change for 2014, the letter reflects your 2013 Part D Plan information.

In summary, If you made a Medicare Part D change for 2014, the letter from Social Security does not reflect your correct monthly premium information.

It is not too late to shop for the best 2014 Medicare Supplement Price. The December 7th deadline only applies to the Medicare Part D Coverage.

As you know, all Medicare Supplement Plans offer the same insurance coverage, so there is no reason to over pay. Senior Healthcare Direct represents all of the top Medicare Supplement Companies.

If you have any questions about Medicare please contact me, my direct phone number is 1-800-525-0299 or you can email me,  Bob@MedicareBob™.com.

As always, we appreciate being your Medicare Insurance Agency.


Robert W. Bache aka “MedicareBob™”
President / Producer
Senior Healthcare Direct
Direct Toll Free: 1-800-525-0299
Company Toll Free: 1-855-368-4717

How much is Medicare Part D?

Can I afford Medicare Part D?

In this MedicareBob video, Robert Bache says Part D plan can be quite affordable and tells you how much a Medicare Part D plan costs. Back in 2013 some plans were as low as $15 in some areas. How much are the most affordable Part D plans in 2020? Call Senior Healthcare Direct at 1-855-368-4717 and find out.

Want to get a quote on Part D plan? Just click the get quote.

Shop For Medicare Part D

In this 2013 MedicareBob video, Robert Bache asks you to email him a list of your medications and your zip code to get a price for Part D plan in your area. However, times have changed and in 2020 we have an online form you can fill out to get your Part D plan price. You can shop now by filling out this Drug Plan Finder form.

Free Generic with Medicare Part D

Which Drug Plan is the best for you?

In this MedicareBob Video, Robert Bache answers the following question:

If you take all generic medications, which Medicare Part D drug plan is the best for you?

Watch the video for the answer.

Get prices on Part D drug plans

Back in 2013, Robert Bache says to email him a list of your medications and he would send you information on Medicare Part D drug plan where all generic drugs had zero copay. Seven years later times have changed. Now you can fill out an online form with your info and list of medication. Then Senior Healthcare Direct licensed agents will research all of the Part D drug plans in your area.

You can find the most cost-effective Medicare Drug Plan using our Drug Plan Finder form.

Medicare Part D, Donut Hole 2013

Donut Hole 2013

In this MedicareBob Video, Robert Bache answers the questions, “What do you have to pay when you enter the donut hole?”

Discover what you have to pay for brand name and generic medications while in the 2013 donut hole.

Donut Hole updates

You can get updates to Donut Hole expenses under the Medicare Part D menu on Senior Healthcare Direct website. Find out what the new donut hole costs in 2020.

When to enroll into Medicare Part D

When to Enroll in Medicare Part D?

Watch this MedicareBob video and discover when you can enroll in Medicare Part D. Robert Bach says you have two opportunities to enroll. Watch this video and find out!

How to save on Part D drug plan?

Back in 2013 Robert Bache asked you to call him directly to shop your drug plan. However, today you can shop for the most cost effective drug plan by filling out our Drug Plan Finder form and a Senior Healthcare Direct licensed agent will contact you. Then we can assist you in choosing the right drug plan that best suits your needs.

Medicare Part D Avoid the Donut Hole

Medicare Part D Avoid the Donut Hole

In this MedicareBob video, Robert Bache gives you tips on how you can avoid the Donut Hole. You will learn what information you need to get the most cost effective Medicare Part D plan. Discover this tip and two more when you watch this video.

Watch MedicareBob Toss an Actual Donut in this Video

Get the tips you need to avoid Medicare Part D the donut hole. For more tips call Senior Healthcare Direct at 1-855-368-4717. Get more info on Medicare Donut Hole 2020.

How Medicare Part D works

How Medicare Part D works

In this MedicareBob video, Robert Bache explains how a Medicare Part D drug plan works. Watch this video to learn about the stages of Part D drug plan.

Stages of Medicare Part D

Medicare Part D has 4 stages, as follows:

  • Deductible
  • Initial Coverage
  • Coverage Gap
  • Catastrophic Coverage

Learn more about these 4 stages including Donut Hole 2020 coverage gap. Senior Healthcare provide Medicare Part D drug plans. Call 1-855-368-4717 for help in choosing the right drug plan for you needs.

How to get the Best Medicare Part D Plan?

The Best Part D Plan

In this MedicareBob video, discover how to get the best Medicare Part D plan. Watch the video for the most cost effective way to get the best price on Part D plan.

Part D Drug Plan Finder

When Robert published this MedicareBob video in 2013, he asks you to email him a list of your medications to find the best Medicare Part D plan. However, Senior Healthcare Direct now has an online Drug Plan Finder form which you can fill out with a list of your medications. Then we can compare available drug plans that cover your specific list of prescriptions, so you can choose the best plan and save money.