From KFF.org —
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time.
1. Medicare Part D enrollment has doubled since 2006, now totaling 45 million people in 2019
A total of 45 million people with Medicare are currently enrolled in plans that provide the Medicare Part D drug benefit, representing 70 percent of all Medicare beneficiaries. This total includes plans open to everyone with Medicare, including stand-alone PDPs and MA-PDs, and plans for retirees of a former employer or union. Part D enrollment has doubled since the program started in 2006, when the number of enrollees was 22.0 million, or roughly half of all Medicare beneficiaries.
2. For the first time since the Part D program started in 2006, enrollment in stand-alone drug plans has decreased somewhat, while enrollment in Medicare Advantage drug plans continues to increase
In 2019, close to half of all Part D enrollees are enrolled in stand-alone PDPs (46%), but nearly 4 in 10 (39%) are in Medicare Advantage prescription drug plans (MA-PDs). The remaining 15 percent of Part D enrollees are in employer/union group plans, both PDPs and MA-PDs. Over time, enrollment in MA-PDs has increased, reflecting enrollment growth in Medicare Advantage plans overall. Between 2018 and 2019, the number of MA-PD enrollees increased by 9 percent, from 16.0 million to 17.4 million, while enrollment in PDPs fell by a modest 0.3 percent, from 20.64 million to 20.57 million.
3. Three firms—UnitedHealth, Humana, and CVS Health—cover nearly 60 percent of all Medicare Part D enrollees in 2019
The top three firms—UnitedHealth, Humana, and CVS Health—cover nearly 60 percent of all beneficiaries enrolled in Part D in 2019 (57%), while the top five firms—including WellCare and Cigna—account for three-quarters (75%) of Part D enrollment (see also Table 1). The recent acquisitions of Aetna by CVS Health and Express Scripts by Cigna have resulted in further consolidation of the Part D marketplace. In particular, between 2018 and 2019, Cigna increased its market share from 3 percent to 8 percent, while CVS Health increased its market share from 14 percent to 17 percent. Under the CVS Health-Aetna merger, Aetna divested its stand-alone PDP business to WellCare, resulting in a more than doubling of WellCare’s Part D market share, from 4 percent in 2018 to 10 percent in 2019.
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