Pink Sheet is part of Pharma Intelligence UK Limited

This site is operated by Pharma Intelligence UK Limited, a company registered in England and Wales with company number 13787459 whose registered office is 5 Howick Place, London SW1P 1WG. The Pharma Intelligence group is owned by Caerus Topco S.à r.l. and all copyright resides with the group.

This copy is for your personal, non-commercial use. For high-quality copies or electronic reprints for distribution to colleagues or customers, please call +44 (0) 20 3377 3183

Printed By

UsernamePublicRestriction

Part D Low-Income Enrollee Shifts: United May Lose 650,000 Members In 2008

Executive Summary

Next year UnitedHealth Group may lose 650,000 of the auto-assigned low-income members currently enrolled in its stand-alone Medicare prescription drug plans

You may also be interested in...



Part D growth through MA plans

Membership in Medicare Advantage drug plans increased approximately 6 percent to 8 million following the 2008 open enrollment period, according to CMS enrollment data. Enrollment in stand-alone Medicare prescription drug plans rose by about 1.2 percent to 17.4 million. The largest gain in the MA-PD market was recorded by Humana, adding 92,000 to a total of 1.2 million, based on an analysis of enrollment numbers by Avalere Health. Market leader UnitedHealth added 21,600 MA-PD members for a total of approximately 1.3 million. However, UnitedHealth lost nearly 600,000 stand-alone PDP members in 2008 (to 4.1 million) and Humana lost about 290,000, to 3.2 million. Due to premium increases, United predicted it would lose up to 650,000 low-income PDP members in 2008 (1"The Pink Sheet," Oct. 1, 2007, p. 12). Humana also had forecast losses based on higher premiums (2"The Pink Sheet," Oct. 8, 2007, p. 18)...

Part D growth through MA plans

Membership in Medicare Advantage drug plans increased approximately 6 percent to 8 million following the 2008 open enrollment period, according to CMS enrollment data. Enrollment in stand-alone Medicare prescription drug plans rose by about 1.2 percent to 17.4 million. The largest gain in the MA-PD market was recorded by Humana, adding 92,000 to a total of 1.2 million, based on an analysis of enrollment numbers by Avalere Health. Market leader UnitedHealth added 21,600 MA-PD members for a total of approximately 1.3 million. However, UnitedHealth lost nearly 600,000 stand-alone PDP members in 2008 (to 4.1 million) and Humana lost about 290,000, to 3.2 million. Due to premium increases, United predicted it would lose up to 650,000 low-income PDP members in 2008 (1"The Pink Sheet," Oct. 1, 2007, p. 12). Humana also had forecast losses based on higher premiums (2"The Pink Sheet," Oct. 8, 2007, p. 18)...

Tighter Part D formularies

CMS' 2008 Medicare Part D plan bidding methodology appears to be generating more restrictive formularies for low-income members, UnitedHealth Group exec Simon Stevens comments during United's third quarter earnings call Oct. 18. "Some of the low-income members are about to be switched to alternative plans whose drugs the formulary excludes altogether - some of the top branded medicines that their physicians are currently prescribing them," he said. Each year, low-income beneficiaries eligible for Medicare subsidies are automatically assigned by CMS to plans with premiums below a certain benchmark. United may lose up to 650,000 low-income Part D members in 2008 as a result of the bidding process (1"The Pink Sheet" Oct. 1, 2007, p. 12). In response to tightening margins in 2008, United chose to raise its premiums, rather than limit its formularies, Stevens indicates...

Latest News
See All
UsernamePublicRestriction

Register

PS048842

Ask The Analyst

Ask the Analyst is free for subscribers.  Submit your question and one of our analysts will be in touch.

Your question has been successfully sent to the email address below and we will get back as soon as possible. my@email.address.

All fields are required.

Please make sure all fields are completed.

Please make sure you have filled out all fields

Please make sure you have filled out all fields

Please enter a valid e-mail address

Please enter a valid Phone Number

Ask your question to our analysts

Cancel