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Over 12,000 home health agencies order zithromax z pak served 5 million disabled and older Americans in 2018. Home health aides help their clients with the tasks of daily living, like eating and showering, as well as with clinical tasks, like taking blood pressure and leading physical therapy exercises. Medicare relies on home health care services because they help patients discharged from the hospital and skilled nursing facilities recover but order zithromax z pak at a much lower cost. Together, Medicare and Medicaid make up 76% of all home health spending.Home health care workers serve a particularly important role in rural areas. As rural areas lose physicians and hospitals, order zithromax z pak home health agencies often replace primary care providers.

The average age of residents living in rural counties is seven years older than in urban counties, and this gap is growing. The need for home health agencies serving the elderly in rural areas will continue to grow over the coming decades.Rural home health agencies face unique challenges. Low concentrations of people are dispersed over large geographic areas leading to long travel times order zithromax z pak for workers to drive to clients’ homes. Agencies in rural areas also have difficulties recruiting and maintaining a workforce. Due to these difficulties, agencies may not be able to serve all rural beneficiaries, initiate care on time, or order zithromax z pak deliver all covered services.Congress has supported measures to encourage home health agencies to work in rural areas since the 1980s by using rural add-on payments.

A rural add-on is a percentage increase on top of per visit and episode-of-care payments. When a home health aide works in a order zithromax z pak rural county, Medicare pays their home health agency a standard fee plus a rural add-on. With a 5% add-on, Medicare would pay $67.78 for an aide home visit in a city and $71.17 for the same care in a rural area.Home health care workers serve a particularly important role in rural areas. As rural areas lose physicians and hospitals, home health agencies often replace primary care providers.Rural add-on payments have fluctuated based on Congressional budgets and political priorities. From 2003 to 2019, the amount Medicare paid agencies changed eight times order zithromax z pak.

For instance, the add-on dropped from 10% to nothing in April 2003. Then, in April 2004, Congress set the rural add-on to 5%.The variation order zithromax z pak in payments created a natural experiment for researchers. Tracy Mroz and colleagues assessed how rural add-ons affected the supply of home health agencies in rural areas. They asked if the number of agencies in urban and rural counties varied depending on the presence and dollar amount of rural add-ons between 2002 and 2018. Though rural add-ons have been in place for over 30 years, researchers had not order zithromax z pak previously investigated their effect on the availability of home healthcare.The researchers found that rural areas adjacent to urban areas were not affected by rural add-ons.

They had similar supply to urban areas whether or not add-ons were in place. In contrast, isolated rural order zithromax z pak areas were affected substantially by add-ons. Without add-ons, the number of agencies in isolated rural areas lagged behind those in urban areas. When the add-ons were at least 5%, the availability of home health in isolated rural areas was comparable to urban areas.In 2020, Congress implemented a system order zithromax z pak of payment reform that reimburses home health agencies in rural counties by population density and home health use. Under the new system, counties with low population densities and low home health use will receive the greatest rural add-on payments.

These payments aim to increase and maintain the availability of care in the most vulnerable rural home health markets. Time will tell if this approach gives sufficient incentive to ensure access to quality care in order zithromax z pak the nation’s most isolated areas.Photo via Getty ImagesStart Preamble Correction In proposed rule document 2020-13792 beginning on page 39408 in the issue of Tuesday, June 30, 2020, make the following correction. On page 39408, in the first column, in the DATES section, “August 31, 2020” should read “August 24, 2020”. End Preamble [FR Doc order zithromax z pak. C1-2020-13792 Filed 7-17-20.

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As ever, the IBMS will be supporting can you drink alcohol with zithromax our member's activities as up and down the country they hold engagement events, workshops and post on social media to help raise awareness of biomedical science Buy amoxil ukamoxil for sale. By supporting this event, we help showcase the roles and specialisms of IBMS members and help them to promote the profession to the public This year's theme is 'All Together Now'. We are excited to support this important awareness campaign to highlight the vital role of biomedical science. Resources to help you celebrate 'Do you know what happens to your sample? can you drink alcohol with zithromax. ' videos We've produced a series of animated videos to show how biomedical scientists process samples.

The videos follow the journey of a sample from their collection at a GP surgery to the delivery of the result to the patient. We encourage can you drink alcohol with zithromax you to share these videos as much as possible throughout the week to expand awareness of what we do to the public. You can share them on your social media channels or include them as part of your presentation or engagement event. buy antibiotics PCR Test [embedded content] Urine Test [embedded content] Tissue Test [embedded content] Blood Test [embedded content] Activity Sheets Download our fun activity sheets to help teach children about Biomedical Science. Each A4 can you drink alcohol with zithromax printable sheet provides instructions and equipment lists to fun and easy to set up activities that introduce children to biomedical science.

The activities cover a variety of disciplines and include. Magnetic Cereal, UV Handwashing, Blood Grouping and DNA Beads. Share your celebrations on Social Media Open the doors to your laboratory through social media and use your social media accounts to raise awareness can you drink alcohol with zithromax of biomedical science and help promote your vital role to the public. Use #AtTheHeartOfHealthcare in your posts and we will help you promote to a wider audience from the IBMS accounts. Likewise, if you follow us on social media you can help us promote our posts by liking and reposting to your followers.

Follow us can you drink alcohol with zithromax on Facebook, Twitter, Instagram and Linkedin!. Let us know how you've celebrated However you choose to get involved, we want to hear from you!. Email us on the address communications@ibms.org and download our proforma if you'd like your event or activity featured in our news roundup of the week!. 28 October 2021 The IBMS celebrates our black can you drink alcohol with zithromax members &. All they contribute to the profession this Black History Month - highlighting their voices &.

Achievements throughout the month of October &. Beyond. I am a HCPC registered Biomedical Scientist with the IBMS Higher Specialist Diploma in Virology and MSc in Clinical Microbiology. I currently work as a Scientific Lead (Chief Biomedical) at the London Medical Laboratory. In my role, I manage and supervise teams of laboratory technicians and support staff within an infectious sciences and virology laboratory.

As a lead scientist, I play a crucial role in encouraging the team to reach goals, all while implementing the laboratory's safety policies and regulations to maintain a safe and productive work environment. I'm an exceptional and diverse leader who uses my talents including my expertise, knowledge and experience within my chosen profession to the fullest by contributing to my community and society at large - especially within STEM and the field of biomedical science (laboratory medicine, pathology). I lead the operational delivery team for buy antibiotics testing services to support the UK response to the zithromax. My leadership skill-set, expertise and knowledge in molecular virology have been instrumental in leading, designing and implementing the June Almeida Lab based Waterloo, London. This was a collaborative project between Kings College London and Viapath Analytics LLP.

For this project, I have a been able to mobilise a workforce team of 100 within a period of few months and deploy them for field work in response to buy antibiotics zithromax. One achievement I am most proud of in my career is my appointment to the IBMS Virology Advisory Panel group. This panel plays an important role in the work of the IBMS, including setting the Scientific programmes for Congress and updating the IBMS qualifications including the HSD. I’m involved in advising the IBMS on quality, training, and safety. I also represent the IBMS on national committees and work with the IBMS education team to help develop professional qualifications, set exam papers, and help organise the scientific lecture programme for IBMS Congress.

As a BAME woman in a leadership position, I have faced a lot of challenges in my career journey to date. Not having a mentor that I could relate to made it difficult to navigate my career path and address situations that might not be inherently easy for me – for example, overall work-life balance. As a professional working mother of two, I’ve had the first-hand experience of overcoming the challenges associated with returning to work at various stages in my career. I understand the associated difficulties with retaining, developing, and progressing female talent to leadership roles and I’ve strived to create awareness of the available support by becoming a role model to other women and inspiring them to continue believing in their leadership potential. Within STEM disciplines, the feeling of exclusion has been attributed to a lack of acknowledgement of and education about the BAME contributions to scientific discoveries and development, along with the lack of BAME role models in senior academic and industrial positions.

Additionally, lack of inclusion can lead to a loss of potential BAME scientists from the community. This loss of BAME individuals, at all career stages, must be addressed. It is crucial that more BAME students and professionals are encouraged and supported to pursue careers in STEM disciplines in order to increase diversity and help solve global challenges and shortages. To this end, I’m a mentor to junior staff members - especially trainees who are completing their IBMS certificate of competence. I have successfully mentored students in their professional training, who have gone on to be practicing registered healthcare scientists.

I strongly believe that STEM qualifications are relevant to todays’ workforce, and I actively advocate for this. Among other things, I am a WISE member, STEM ambassador, volunteer public engagement professional for InspiringtheFuture, IBMS continuous professional development (CPD) officer and journal club presenter/organiser. These roles involve outreach activities, visiting primary and secondary schools and colleges across the UK to talk about my job, career, and the education route I took - inspiring students that science is “for them”. What are the biggest lessons you have learned in your career?. Being open to life lessons has helped me evolve and be more successful in both my professional and personal life - providing me with the tools I needed to grow as an individual.

I have found that the most effective life lessons are the ones I've learnt through personal experiences. One of the biggest lessons I have learnt in my career was striving to avoid stagnation. I believe that those who always strive to learn more and continue to progress through times of stagnation are those who succeed.

Resources to Buy amoxil ukamoxil for sale help you celebrate 'Do you know what order zithromax z pak happens to your sample?. ' videos We've produced a series of animated videos to show how biomedical scientists process samples. The videos follow the journey of a sample from their collection at a GP surgery to the delivery of the result to the patient.

We encourage you to share these videos as much as possible throughout the week to expand awareness of what order zithromax z pak we do to the public. You can share them on your social media channels or include them as part of your presentation or engagement event. buy antibiotics PCR Test [embedded content] Urine Test [embedded content] Tissue Test [embedded content] Blood Test [embedded content] Activity Sheets Download our fun activity sheets to help teach children about Biomedical Science.

Each A4 printable sheet provides instructions and equipment lists to fun and easy to set up order zithromax z pak activities that introduce children to biomedical science. The activities cover a variety of disciplines and include. Magnetic Cereal, UV Handwashing, Blood Grouping and DNA Beads.

Share your celebrations on Social Media Open the doors to your laboratory through social media and use your social media accounts to raise order zithromax z pak awareness of biomedical science and help promote your vital role to the public. Use #AtTheHeartOfHealthcare in your posts and we will help you promote to a wider audience from the IBMS accounts. Likewise, if you follow us on social media you can help us promote our posts by liking and reposting to your followers.

Follow us on order zithromax z pak Facebook, Twitter, Instagram and Linkedin!. Let us know how you've celebrated However you choose to get involved, we want to hear from you!. Email us on the address communications@ibms.org and download our proforma if you'd like your event or activity featured in our news roundup of the week!.

28 October order zithromax z pak 2021 The IBMS celebrates our black members &. All they contribute to the profession this Black History Month - highlighting their voices &. Achievements throughout the month of October &.

Beyond. I am a HCPC registered Biomedical Scientist with the IBMS Higher Specialist Diploma in Virology and MSc in Clinical Microbiology. I currently work as a Scientific Lead (Chief Biomedical) at the London Medical Laboratory.

In my role, I manage and supervise teams of laboratory technicians and support staff within an infectious sciences and virology laboratory. As a lead scientist, I play a crucial role in encouraging the team to reach goals, all while implementing the laboratory's safety policies and regulations to maintain a safe and productive work environment. I'm an exceptional and diverse leader who uses my talents including my expertise, knowledge and experience within my chosen profession to the fullest by contributing to my community and society at large - especially within STEM and the field of biomedical science (laboratory medicine, pathology).

I lead the operational delivery team for buy antibiotics testing services to support the UK response to the zithromax. My leadership skill-set, expertise and knowledge in molecular virology have been instrumental in leading, designing and implementing the June Almeida Lab based Waterloo, London. This was a collaborative project between Kings College London and Viapath Analytics LLP.

For this project, I have a been able to mobilise a workforce team of 100 within a period of few months and deploy them for field work in response to buy antibiotics zithromax. One achievement I am most proud of in my career is my appointment to the IBMS Virology Advisory Panel group. This panel plays an important role in the work of the IBMS, including setting the Scientific programmes for Congress and updating the IBMS qualifications including the HSD.

I’m involved in advising the IBMS on quality, training, and safety. I also represent the IBMS on national committees and work with the IBMS education team to help develop professional qualifications, set exam papers, and help organise the scientific lecture programme for IBMS Congress. As a BAME woman in a leadership position, I have faced a lot of challenges in my career journey to date.

Not having a mentor that I could relate to made it difficult to navigate my career path and address situations that might not be inherently easy for me – for example, overall work-life balance. As a professional working mother of two, I’ve had the first-hand experience of overcoming the challenges associated with returning to work at various stages in my career. I understand the associated difficulties with retaining, developing, and progressing female talent to leadership roles and I’ve strived to create awareness of the available support by becoming a role model to other women and inspiring them to continue believing in their leadership potential.

Within STEM disciplines, the feeling of exclusion has been attributed to a lack of acknowledgement of and education about the BAME contributions to scientific discoveries and development, along with the lack of BAME role models in senior academic and industrial positions. Additionally, lack of inclusion can lead to a loss of potential BAME scientists from the community. This loss of BAME individuals, at all career stages, must be addressed.

It is crucial that more BAME students and professionals are encouraged and supported to pursue careers in STEM disciplines in order to increase diversity and help solve global challenges and shortages. To this end, I’m a mentor to junior staff members - especially trainees who are completing their IBMS certificate of competence. I have successfully mentored students in their professional training, who have gone on to be practicing registered healthcare scientists.

I strongly believe that STEM qualifications are relevant to todays’ workforce, and I actively advocate for this. Among other things, I am a WISE member, STEM ambassador, volunteer public engagement professional for InspiringtheFuture, IBMS continuous professional development (CPD) officer and journal club presenter/organiser. These roles involve outreach activities, visiting primary and secondary schools and colleges across the UK to talk about my job, career, and the education route I took - inspiring students that science is “for them”.

What are the biggest lessons you have learned in your career?. Being open to life lessons has helped me evolve and be more successful in both my professional and personal life - providing me with the tools I needed to grow as an individual. I have found that the most effective life lessons are the ones I've learnt through personal experiences.

One of the biggest lessons I have learnt in my career was striving to avoid stagnation. I believe that those who always strive to learn more and continue to progress through times of stagnation are those who succeed. Another important lesson I've learned in my career is how valuable connections with other people are - this includes relationships with professional colleagues, friends and family members.

Each relationship I've built adds another beam of support to what I'm building for myself. Being able to remain positive and look at things with optimism is an invaluable life lesson.

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The Centers is zithromax a strong antibiotic for Medicare & article source. Medicaid Services (CMS) and Mathematica released a fifth and final toolkit and two case studies to highlight strategies that Accountable Care Organizations (ACOs) and End-Stage Renal Disease Seamless Care Organizations (ESCOs) use to improve quality of care, lower health care costs, and enhance beneficiaries’ experience. Mathematica completed this work as part of a contract with CMS.CMS is zithromax a strong antibiotic and Mathematica conducted focus groups with representatives from 13 ACOs participating in the Medicare Shared Savings Program and the Next Generation ACO Model to identify strategies for providing value-based care.

With insights gained through these focus groups and other CMS-sponsored events, CMS’s ACO Learning System team developed the Operational Elements Toolkit. The toolkit presents fundamental strategies that Medicare ACOs use to begin or refine operations and considers approaches to meet the following objectives. Establishing strategic is zithromax a strong antibiotic partnerships to strengthen or expand an organization Understanding beneficiaries’ care needs and preferences Harnessing data to improve performance and support quality reportingThe Operational Elements Toolkit is part of a broader series of resources that explores how ACOs and ESCOs provide value-based care.

CMS and Mathematica added to these resources with two new case studies that highlight the following strategies. Partnering with emergency departments to improve care coordination services (Reliance Healthcare) Creating an Innovation Fund that distributes grants to local organizations to improve quality, cost, and care experience (OneCare Vermont)For more information about this toolkit and other resources highlighting ACO and ESCO initiatives—including previous toolkits on care transformation, provider engagement, beneficiary engagement, and care coordination, and almost two dozen case studies—please visit CMS’s website.Parents with young children in early care and education programs like Early Head Start may also need other kinds of support. They may need affordable higher education alternatives like community how to get zithromax over the counter college, or job training and economic support from workforce development programs is zithromax a strong antibiotic.

Helping clients navigate the complexities of different programs can be difficult for service providers, especially when it comes to ensuring the right coordination between services for parents and their children. Better program coordination may lead to greater benefits for families than individual service providers could achieve alone. Coordination requires systems change, however—change achieved through active partnerships, is zithromax a strong antibiotic engaged leadership, cooperative planning, data-informed decision making, strategic use of resources, and innovative problem solving.

Mathematica’s new digital resource on improving family outcomes through coordinated services speaks directly to this need. Our partnership framework, which shows how local partnerships tend to evolve through stages of cooperation, coordination, and collaboration, was developed to help staff document their specific approaches to coordinated services and assess the approaches’ quality and intensity necessary to have an impact on parent and child outcomes. Beyond sharing the tools and information available now, the digital resource describes upcoming is zithromax a strong antibiotic initiatives that will help programs use rapid-cycle testing to pilot their approach to coordinated services and give decision makers timely and actionable evidence on possible ways to improve program outcomes.

We also bring to light several culturally responsive best practices and innovative methods that multigenerational programs can use to overcome access disparities among communities of color and communities experiencing poverty. For more information about Mathematica’s coordinated services work, or to speak with one of our experts, email info@mathematica-mpr.com..

The Centers for Medicare & order zithromax z pak http://www.ec-entreilletrhin-wittisheim.ac-strasbourg.fr/WP/?page_id=954. Medicaid Services (CMS) and Mathematica released a fifth and final toolkit and two case studies to highlight strategies that Accountable Care Organizations (ACOs) and End-Stage Renal Disease Seamless Care Organizations (ESCOs) use to improve quality of care, lower health care costs, and enhance beneficiaries’ experience. Mathematica completed this work as part of a contract with order zithromax z pak CMS.CMS and Mathematica conducted focus groups with representatives from 13 ACOs participating in the Medicare Shared Savings Program and the Next Generation ACO Model to identify strategies for providing value-based care.

With insights gained through these focus groups and other CMS-sponsored events, CMS’s ACO Learning System team developed the Operational Elements Toolkit. The toolkit presents fundamental strategies that Medicare ACOs use to begin or refine operations and considers approaches to meet the following objectives. Establishing strategic partnerships to strengthen or expand an organization Understanding beneficiaries’ care needs and order zithromax z pak preferences Harnessing data to improve performance and support quality reportingThe Operational Elements Toolkit is part of a broader series of resources that explores how ACOs and ESCOs provide value-based care.

CMS and Mathematica added to these resources with two new case studies that highlight the following strategies. Partnering with emergency departments to improve care coordination services (Reliance Healthcare) Creating an Innovation Fund that distributes grants to local organizations to improve quality, cost, and care experience (OneCare Vermont)For more information about this toolkit and other resources highlighting ACO and ESCO initiatives—including previous toolkits on care transformation, provider engagement, beneficiary engagement, and care coordination, and almost two dozen case studies—please visit CMS’s website.Parents with young children in early care and education programs like Early Head Start may also need other kinds of support. They may order zithromax z pak need affordable higher education alternatives like community college, or job training and economic support from workforce development programs.

Helping clients navigate the complexities of different programs can be difficult for service providers, especially when it comes to ensuring the right coordination between services for parents and their children. Better program coordination may lead to greater benefits for families than individual service providers could achieve alone. Coordination requires systems change, however—change achieved through active partnerships, engaged leadership, cooperative planning, data-informed decision making, strategic use of resources, and innovative order zithromax z pak problem solving.

Mathematica’s new digital resource on improving family outcomes through coordinated services speaks directly to this need. Our partnership framework, which shows how local partnerships tend to evolve through stages of cooperation, coordination, and collaboration, was developed to help staff document their specific approaches to coordinated services and assess the approaches’ quality and intensity necessary to have an impact on parent and child outcomes. Beyond sharing the tools and information available now, the digital resource describes upcoming initiatives that will help programs use rapid-cycle testing to pilot their approach to order zithromax z pak coordinated services and give decision makers timely and actionable evidence on possible ways to improve program outcomes.

We also bring to light several culturally responsive best practices and innovative methods that multigenerational programs can use to overcome access disparities among communities of color and communities experiencing poverty. For more information about Mathematica’s coordinated services work, or to speak with one of our experts, email info@mathematica-mpr.com..

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Over the last decade, Medicare Advantage, the private plan alternative to traditional Medicare, has taken is zithromax effective for sinus on a larger role in the Medicare program https://labourtoo.org.uk/how-do-i-get-flagyl/. In 2020, more than 24 million Medicare beneficiaries are enrolled in a Medicare Advantage plan. This brief provides an overview of the Medicare Advantage plans that are is zithromax effective for sinus available for 2021 and key trends over time.Plan Offerings in 2021Number of PlansNumber of Plans Available to Beneficiaries.

For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade (Figure 1).Figure 1. The average Medicare beneficiary has is zithromax effective for sinus access to 33 Medicare Advantage plans in 2021, an increase from prior yearsAmong the 33 Medicare Advantage plans generally available for individual enrollment to the average Medicare beneficiary, 27 of the plans include prescription drug coverage (MA-PDs). These numbers exclude employer or union-sponsored group plans, Special Needs Plans (SNPs) and PACE plans, which are only available to select populations.Total Number of Plans.

In total, 3,550 Medicare Advantage plans are available nationwide for individual enrollment in 2021 – a 13 percent increase (402 is zithromax effective for sinus more plans) from 2020 and the largest number of plans ever available (Figure 2. Appendix Table 1). The vast majority (89 percent) of all Medicare Advantage plans offered include prescription is zithromax effective for sinus drug coverage in 2021.

.As in prior years, HMOs continue to account for about two-thirds (62%) of all plans offered in 2021. The availability of local PPOs has increased rapidly over recent is zithromax effective for sinus years. In 2021, one-third of plans offered are local PPOs, compared to a quarter in 2018.

Between 2020 and 2021, the number of regional PPOs has remained constant, while the number of private fee-for-service plans has continued to decline.The is zithromax effective for sinus growth in number of plans varies across states and counties, with the preponderance of the growth occurring in Florida and California (41 more and 30 more plans, respectively. Data not shown). Virginia has 6 fewer plans available for 2021 than in 2020, while South Carolina has 3 fewer plans, and Maryland and Nebraska each have one fewer plan available in 2021 than in 2020.While many employers and unions also offer Medicare Advantage plans is zithromax effective for sinus to their retirees, no information about these 2021 plan offerings is made available by CMS to the public during the Medicare open enrollment period because these plans are not available to the general Medicare population.One notable change for 2021 is that people with end-stage renal disease (ESRD) are eligible to enroll in Medicare Advantage plans.

Prior to this change, people with ESRD were not able to enroll in most Medicare Advantage plans, subject to limited exceptions, such as C-SNPS for people with ESRD.Special Needs Plans (SNPs). More SNPs are available for 2021 than in any year since they were authorized, increasing from 855 plans in 2020 to 975 plans in 2021, a 14 percent increase (Figure 3). .The rise in SNPs for people who require an institutional-level of care (I-SNPs) has been particularly notable, more than doubling from 83 plans in 2017 to is zithromax effective for sinus 174 plans in 2021.

I-SNPs may be attractive to insurers because they tend to have much lower marketing costs than other plan types since they are often the only available option for people to receive their Medicare benefits in certain retirement communities and nursing homes. The number of SNPs for people dually eligible for Medicare and Medicaid (D-SNPs) has also increased sharply over the past five years, rising from 373 dual SNPs in 2017 to 598 dual SNPs in 2021, a 60% increase, suggesting insurers’ continue to be interested in managing the care of this high-need population.The number of SNPs offered for people with chronic conditions (C-SNPs) is also increasing in 2021, most of which focus on people with diabetes, heart is zithromax effective for sinus disease, or lung conditions, as has been the case since the inception of C-SNPs. For 2021, three firms are offering C-SNPs for people with dementia (the same as 2020), two firms are offering a C-SNP for people with mental health conditions (up one from 2020), three firms are offering C-SNPs for people with end-stage renal disease (one fewer than 2020) and two firms are offering C-SNPs for people with HIV/AIDS (similar to 2020).Variation in the Number of Plans, by Geographic Area.

On average, beneficiaries in metropolitan areas can choose from about twice as many Medicare Advantage plans as beneficiaries in non-metropolitan areas (36 plans versus is zithromax effective for sinus 20 plans, respectively).In 11 percent of counties (accounting for 41% of beneficiaries), beneficiaries can choose from more than 35 plans in 2021, including eleven counties in Ohio and five counties in Pennsylvania where more than 60 Medicare Advantage plans are available (Figure 4). In contrast, in 4 percent of counties (accounting for 1% of beneficiaries), beneficiaries can choose from two or fewer Medicare Advantage plans. The number of counties with no is zithromax effective for sinus Medicare Advantage plans for 2021 is 82, similar to 2020.

As in prior years, there are no Medicare Advantage plans offered in Alaska. Additionally, no Medicare is zithromax effective for sinus Advantage plans are available in territories other than Puerto Rico. .Access to Medicare Advantage Plans, by Plan TypeAs in recent years, virtually all Medicare beneficiaries (99%) have access to a Medicare Advantage plan as an alternative to traditional Medicare, including almost all beneficiaries in metropolitan areas (99.9%) and the vast majority of beneficiaries in non-metropolitan areas (97.7%).

In non-metropolitan counties, a smaller share of beneficiaries have access to HMOs (87% in non-metropolitan versus 99% in metropolitan counties) or local PPOs (89% in non-metropolitan versus 96% in metropolitan counties), and a slightly larger share of beneficiaries have access to is zithromax effective for sinus regional PPOs (77% in non-metropolitan counties versus 72% in metropolitan counties). Number of FirmsThe average Medicare beneficiary is able to choose from plans offered by 8 firms in 2021, one more than in 2020 (Figure 5). Despite most beneficiaries having access to plans operated by several different firms, enrollment is concentrated in plans operated is zithromax effective for sinus by UnitedHealthcare, Humana, and Blue Cross Blue Shield affiliates.Figure 5.

More than one-quarter of beneficiaries can choose among Medicare Advantage plans offered by 10 or more firmsMore than one-quarter of beneficiaries (27%) are able to choose from plans offered by 10 or more firms. Fifteen or more firms are offering Medicare Advantage plans in three counties. Orange County, California and Summit and Medina Counties is zithromax effective for sinus in Ohio.

In contrast, in 109 counties, most of which are rural counties with relatively few Medicare beneficiaries (1% of total), only one firm will offer Medicare Advantage plans in 2021. Over the past several years, the is zithromax effective for sinus number of counties with a single firm offering Medicare Advantage plans has fallen substantially. As recently as 2019, there was a single firm offering plans in nearly 200 counties.UnitedHealthcare and Humana, the two firms with the most Medicare Advantage enrollees in 2020, have large footprints across the country, offering plans in most counties.

Humana is is zithromax effective for sinus offering plans in 84 percent of counties and UnitedHealthcare is offering plans in 66 percent of counties in 2021 (Figure 6). More than 8 in 10 (87%) Medicare beneficiaries have access to at least one Humana plan and 86 percent have access to at least one UnitedHealthcare plans. .Most major Medicare Advantage firms have also expanded the is zithromax effective for sinus number of counties where they are offering plans.

UnitedHealthcare is offering plans in 2,117 counties in 2021, an increase of 245 from 2021, while Humana is offering plans in 2,703 counties in 2021, an increase of 33 from 2020. Centene is offering is zithromax effective for sinus plans in 1,129 counties in 2021, an increase of 261 plans from 2020. Blue Cross Blue Shield Affiliates are offering plans in 1,181 counties, an increase of 152 plans.

CVS Health is offering plans in 1,759 counties, an increase of 119 plans is zithromax effective for sinus . And Cigna is offering plans in 369 counties, an increase of 67 plans. Kaiser Permanente had the smallest growth and is offering plans in 109 counties, an increase of 4 plans.New Market Entrants and ExitsMedicare Advantage continues to be an attractive market for insurers, with 14 firms entering the market for the first time in 2021, collectively accounting for about 6 percent of the growth in the number of plans available for general enrollment and about 10 percent of the growth in SNPs is zithromax effective for sinus (Appendix Table 2).

Nine new entrants are offering HMOs available for individual enrollment. Five of the new is zithromax effective for sinus entrants are offering SNPs. Three firms are offering D-SNPs for people dually eligible for Medicaid, three firms are offering C-SNPs for people with select chronic conditions, and one firm is offering an I-SNPs Four of the new firm entrants are offering plans in California, two are offering plans in Indiana, and the remainder are offering plans in at least one of ten other states (Colorado, Georgia, Illinois, Mississippi, Missouri, Ohio, Texas, Utah, and Wisconsin).Six firms that previously participated in the Medicare Advantage market are not offering plans in 2021.

Two of the firms (ApexHealth, Inc. And Clarion Health) offered plans for the first is zithromax effective for sinus time in 2020, but did not appear to enroll any participants. The other four firms had very low enrollment in 2020.

Three of the six exiting firms offered plans in New York.PremiumsThe vast majority of Medicare Advantage plans for is zithromax effective for sinus individual enrollment (89%) will include prescription drug coverage (MA-PDs), and 54 percent of these plans will charge no premium, other than the Part B premium, similar to 2020. More than nine out of ten beneficiaries (96%) have access to a MA-PD with no monthly premium in 2021. However, in Wyoming, beneficiaries do not have access to a zero-premium MA-PD, and in Idaho, less is zithromax effective for sinus than half of beneficiaries have access to a zero-premium MA-PD.In 2020, 60 percent of enrollees in MA-PD plans pay no premium other than the Medicare Part B premium of $144.60 per month.

Based on enrollment in March 2020, nearly one in five enrollees (18%) pay at least $50 a month, and 6 percent pay $100 or more. CMS announced that the average monthly plan premium among all Medicare Advantage enrollees in 2021, including those who pay no premium for their Medicare Advantage plan, is expected to decrease 11 percent from 2020 to $21 a is zithromax effective for sinus month. CMS does not disclose the methods or assumptions used in deriving their calculations, but since most Medicare Advantage enrollees pay no additional premium, the average they report is heavily influenced by zero-premium plans, and does not reflect the average premium paid by those who are in plans with an additional premium.Extra BenefitsMedicare Advantage plans may provide extra benefits that are not available in traditional Medicare, are considered “primarily health related,” and can use rebate dollars (including bonus payments) to help cover the cost of these extra benefits.

Beginning in 2019, CMS expanded the is zithromax effective for sinus definition of “primarily health related” to allow Medicare Advantage plans to offer additional supplemental benefits. Medicare Advantage plans may also restrict the availability of these extra benefits to certain subgroups of beneficiaries, such as those with diabetes or congestive heart failure, making different benefits available to different enrollees.Beginning in 2020, Medicare Advantage plans have also been able to offer extra benefits that are not primarily health related for chronically ill beneficiaries, known as Special Supplemental Benefits for the Chronically Ill (SSBCI). Information on the availability of SSBCI is zithromax effective for sinus for 2021 has not yet been published by CMS, but may include services such as pest control, food and produce (beyond a limited basis), and non-medical transportation.

Since plans are permitted to offer these benefits non-uniformly to enrollees, it will be important to examine how these benefits are distributed across subgroups of enrollees.Availability of Extra Benefits in Plans for General Enrollment. Historically, the most offered extra benefits were is zithromax effective for sinus fitness, dental, vision, and hearing. Nearly two-thirds of plans (68%) provide all four of these benefits for 2021.

Though these benefits are widely available, the scope of specific services varies. For example, a dental benefit may include cleanings only or more comprehensive is zithromax effective for sinus coverage. As of 2020, Medicare Advantage plans have also been allowed to offer more telehealth benefits than traditional Medicare (though Medicare has temporarily expanded these benefits during the zithromax).

The vast majority (98%) of Medicare Advantage plans are offering telehealth is zithromax effective for sinus in 2021 (up from 91% in 2020) (Figure 7).Figure 7. Most Medicare Advantage plans provide fitness and dental benefits but much fewer provide in-home or caregiver supportOther extra benefits that are frequently offered for 2021 include over the counter items (75%), meal benefits, such as a cooking class, nutrition education, or meal delivery (55%), and transportation benefits (36%).Less than 10 percent of plans provide bathroom safety devices (6%) or in-home support (6%).Availability of Extra Benefits in Special Needs Plans. SNPs are designed to serve a disproportionately high-need population, and a somewhat larger percentage of SNPs than plans for other Medicare beneficiaries provide their enrollees with over the counter items (91%), transportation is zithromax effective for sinus benefits (85%) and meal benefits (63%).

Similar to plans available for general enrollment, a relatively small share of SNPs provide bathroom safety devices (11%) or in-home support (18%).Access to Extra Benefits. Virtually all Medicare beneficiaries live in a county where at least one Medicare Advantage plan available for general enrollment has some extra benefits not covered by traditional Medicare, with 98% having access to some dental, fitness, vision, and hearing benefits is zithromax effective for sinus for 2021. The vast majority of beneficiaries also have access to telehealth benefits (99%), over the counter items (99%), transportation assistance (95%) and a meal benefit (98%), but far fewer have access to bathroom safety (55%) or in-home support (62%).DiscussionMore Medicare Advantage plans are being offered for 2021 than in any other year.

Fourteen insurers are entering the Medicare Advantage market for the first time, and six insurers are exiting the market, suggesting thatMedicare Advantage remains an attractive, profitable is zithromax effective for sinus market for insurers. As in prior years, some (mostly non-metropolitan) counties are less attractive to insurers, with fewer firms and plans available, though the number of areas where this is the case has declined over time. Overall, more than 99 percent of beneficiaries will have access to one or more Medicare Advantage plans in 2021, similar to prior years is zithromax effective for sinus .

With more firms offering SNPs and the number of SNPs rapidly growing, there may be greater focus on how well high-need, vulnerable beneficiaries are being served by Medicare Advantage plans, including SNPs as well as plans for general enrollment. As Medicare Advantage enrollment continues is zithromax effective for sinus to grow, insurers seem to be responding by offering more plans and choices to the people on Medicare. This analysis focuses on the Medicare Advantage marketplace in 2021 and trends over time.

The analysis includes more than 24 million enrollees in Medicare Advantage plans in 2020.Data on Medicare Advantage plan availability, enrollment, and premiums were collected from a set of data files released by the Centers for Medicare &. Medicaid Services (CMS):Medicare Advantage plan landscape files, released each fall prior to the annual enrollment periodMedicare Advantage plan and premium files, released each fallMedicare Advantage plan crosswalk files, released each fallMedicare Advantage contract/plan/state/county level enrollment files, released on a monthly basisMedicare Advantage plan benefit package files, released each fallMedicare is zithromax effective for sinus Enrollment Dashboard files, released on a monthly basisIn previous years, KFF has used the Medicare Advantage Penetration Files to calculate the number of Medicare beneficiaries eligible for Medicare. The Medicare Advantage Penetration Files includes people who were previously, but no longer covered by Medicare (e.g., people who obtained employer-sponsored health insurance coverage after initially enrolling in Medicare).

It also includes people within 5 months of their 65th birthday, but not is zithromax effective for sinus yet age 65. In addition, CMS has identified an issue where beneficiaries with multiple addresses were double counted in the Penetration File. KFF has refined its approach this year and is using the Medicare Enrollment Dashboard to calculate the number of Medicare beneficiaries because it only includes Medicare beneficiaries with either Part A or Part B coverage, which is is zithromax effective for sinus a more accurate estimate of the Medicare population.

The numbers published here supersede all prior estimates by KFF of the number of Medicare beneficiaries.Jeannie Fuglesten Biniek, Meredith Freed, and Tricia Neuman are with KFF.Anthony Damico is an independent consultant.During the Medicare open enrollment period from October 15 to December 7 each year, beneficiaries can enroll in a plan that provides Part D drug coverage, either a stand-alone prescription drug plan (PDP) as a supplement to traditional Medicare, or a Medicare Advantage prescription drug plan (MA-PD), which covers all Medicare benefits, including drugs. Among the 46 million Part D enrollees is zithromax effective for sinus in 2020, 20.2 million (44%) are in PDPs and 19.3 million (41%) are in MA-PDs (excluding the 7.0 million (15%) in employer-only group PDPs and MA-PDs). This issue brief provides an overview of Medicare Part D drug plans that will be available in 2021 and key trends over time.Part D Plan AvailabilityThe Average Medicare Beneficiary Has a Choice of Nearly 60 Medicare Plans with Part D Drug Coverage in 2021, Including 30 Medicare Stand-alone Drug Plans and 27 Medicare Advantage Drug PlansFigure 1.

The Average Medicare Beneficiary Has a Choice of Nearly 60 Medicare Plans Offering Drug Coverage in 2021, Including 30 Stand-alone is zithromax effective for sinus Drug Plans and 27 Medicare Advantage Drug PlansA larger number of Part D plans will be offered in 2021 than in recent years. The average Medicare beneficiary will have a choice of 30 stand-alone PDPs in 2021, two more PDP options than in 2020, and eight more than in 2017, a 36% increase (Figure 1). Although the number of PDP options in 2021 is half of what it was at the peak in 2007 (when there were 56 PDP options, on average), this is the fourth year in a row with an increase in the average number of stand-alone drug plan is zithromax effective for sinus options.In 2021, beneficiaries will also have access to 27 MA-PDs, on average, a 71% increase in MA-PD options since 2017 (excluding Medicare Advantage plans that do not offer the drug benefit and plans not available to all beneficiaries.

Overall, an average of 33 Medicare Advantage plan options will be available in 2021).Based on September 2020 enrollment, 8 out of 10 PDP enrollees (80%) in 2021 are projected to be in PDPs operated by just four firms. UnitedHealth, Centene (which acquired WellCare in 2020), Humana, and CVS Health (based on PDP is zithromax effective for sinus enrollment as of September 2020). All four firms offer PDPs in all 34 PDP regions in 2021.A Total of 996 Medicare Part D Stand-Alone Prescription Drug Plans Will Be Offered in 2021, a 5% Increase From 2020 and a 34% Increase Since 2017 Figure 2.

A Total of 996 Medicare Part D Stand-Alone Prescription Drug Plans Will Be Offered in 2021, a 5% Increase From 2020 and a 34% Increase Since 2017​A total of 996 PDPs will be offered in the 34 PDP regions in 2021 (plus another 11 PDPs in the territories), an increase of 48 PDPs (5%) over 2020, and 250 more PDPs (a 34% increase) since 2017 (Figure 2). This increase is primarily due to is zithromax effective for sinus the Trump Administration’s elimination of the “meaningful difference” requirement for enhanced benefit PDPs offered by the same organization in the same region. Eliminating this requirement means that PDP sponsors no longer have to demonstrate that their enhanced PDPs offered in the same region are meaningfully different in terms of enrollee out-of-pocket costs.

In 2021, 62% of PDPs (618 plans) will offer enhanced Part D benefits—a 60% increase in the availability of enhanced-benefit PDPs since 2017, when just over half of PDPs (387 plans) offered enhanced benefits.The number of PDPs per region in 2021 will range from 25 PDPs in Alaska to 35 PDPs in Texas and will be the same or higher in 32 of is zithromax effective for sinus the 34 PDP regions compared to 2020 (see map, Table 1). Part D PremiumsThe Estimated Average Monthly Premium for Medicare PDPs Is Projected to Increase by 9% to $41 in 2021, Based on Current EnrollmentFigure 3. The Estimated Average Monthly Premium for Medicare PDPs Is Projected to Increase by 9% to $41 is zithromax effective for sinus in 2021, Based on Current Enrollment​The estimated national average monthly PDP premium for 2021 is projected to increase by 9% to $41, from $38 in 2021, weighted by September 2020 enrollment (Figure 3).

It is likely that the actual average weighted premium for 2021, after taking into account enrollment choices by new enrollees and plan changes by current enrollees, will be somewhat lower than the estimated average. CMS reported that the average premium for basic Part D coverage offered by PDPs and is zithromax effective for sinus MA-PDs will be an estimated $30 in 2021. Our premium estimate is higher because it is based on PDPs only (excluding MA-PDs) and includes PDPs offering both basic and enhanced coverage (enhanced plans, which account for 62% of all PDPs in 2021, have higher premiums than basic plans, on average).Average Monthly Premiums for the 21 National Part D Stand-alone PDPs Are Projected to Range from $7 to $89 in 2021, with Higher Average Premiums for Enhanced Benefits and Zero-Deductible PDPsFigure 4.

Average Monthly Premiums for the 21 National Part D Stand-alone Drug Plans Are Projected to Range from $7 to $89 in 2021​PDP premiums will vary widely across plans in 2021, as in previous years is zithromax effective for sinus (Figure 4, Table 2). Among the 21 PDPs available nationwide, average premiums will range from a low of $7 per month for SilverScript SmartRx to a high of $89 per month for AARP MedicareRx Preferred.Changes to premiums from 2020 to 2021, averaged across regions and weighted by 2020 enrollment, also vary widely across PDPs, as do the absolute amounts of monthly premiums for 2021.The 1.9 million non-LIS enrollees in the largest PDP, CVS Health’s SilverScript Choice (which had a total of 3.9 million enrollees in 2020, including those receiving low-income subsidies) will face a modest $1 (2%) decrease in their average monthly premium, from $29 in 2020 to $28 in 2021.In contrast, the 1.8 million non-LIS enrollees in the second largest PDP, AARP MedicareRx Preferred, will face a $10 (12%) increase in their average monthly premium between 2020 and 2021, from $79 to $89. This is the highest monthly premium among the national PDPs in 2021.The 1.3 million non-LIS enrollees in the fourth largest PDP, Humana Premier Rx, will see a $7 (13%) increase in their monthly premium, from $58 in 2020 to $65 in 2021.Most Part D stand-alone drug plans in 2021 (62% of is zithromax effective for sinus PDPs) will offer enhanced benefits for a higher monthly premium.

Enhanced benefits can include a lower (or no) deductible, reduced cost sharing, or a higher initial coverage limit than under the standard benefit design. The average premium in 2021 for enhanced benefit PDPs is $51, which is 55% higher than the monthly premium for PDPs offering the basic benefit ($33) (weighted by September 2020 enrollment).In 2021, a large majority of PDPs (86%) will charge a deductible, is zithromax effective for sinus with most PDPs (67%) charging the standard amount of $445 in 2021. Across all PDPs, the average deductible in 2021 will be $345 (weighted by September 2020 enrollment).

The average monthly premium in 2021 for PDPs that charge no deductible is $88, nearly three times the monthly premium for PDPs that charge the standard deductible ($34) or a partial deductible ($31) (weighted by September 2020 enrollment).Nearly 8 in 10 Part D Stand-alone Drug Plan Enrollees Without Low-income Subsidies Will Pay Higher Premiums in 2021 is zithromax effective for sinus If They Stay in Their Current PlanFigure 5. Nearly 8 in 10 Part D Stand-alone Drug Plan Enrollees Without Low-income Subsidies Will Pay Higher Premiums in 2021 If They Stay in Their Current Plan​Most (78%, or 10 million) of the 13.4 million Part D PDP enrollees who are responsible for paying the entire premium (which excludes Low-Income Subsidy (LIS) recipients) will see their monthly premium increase in 2021 if they stay in their same plan, while 2.8 million (21%) will see a premium reduction if they stay in their same plan (Figure 5).Nearly 2 million non-LIS enrollees (13%) will see a premium increase of $10 or more per month, while significantly fewer (0.2 million non-LIS enrollees, or 1%) will see a premium reduction of the same magnitude. One-third (34%) of non-LIS enrollees (4.6 million) are projected to pay monthly premiums of at least $60 if they stay in their current plans, and more than 230,000 (2% of non-LIS enrollees) are projected to pay monthly premiums of at least $100.The Average Monthly Part D Premium in 2021 for the Subset of Enhanced Stand-alone Drug Plans Covering Insulin at a $35 Monthly Copay Is Substantially Higher Than Premiums for Other PDPsFigure 6.

The Average Monthly Part D Premium in 2021 for the Subset of Enhanced Stand-alone Drug Plans Covering Insulin at a $35 Monthly Copay is Substantially Higher than Premiums for Other Plans​New for 2021, beneficiaries in each state will have the option to enroll in a Part D plan participating in the Trump Administration’s new Innovation Center model in which enhanced drug plans cover insulin products at is zithromax effective for sinus a monthly copayment of $35 in the deductible, initial coverage, and coverage gap phases of the Part D benefit. Participating plans do not have to cover all insulin products at the $35 monthly copayment amount, just one of each dosage form (vial, pen) and insulin type (rapid-acting, short-acting, intermediate-acting, and long-acting).In 2021, a total of 1,635 enhanced Part D plans will participate in this model, which represents just over 30% of both PDPs (310 plans) and MA-PDs (1,325 plans) available in 2021, including plans in the territories. Between 8 and 10 enhanced PDPs is zithromax effective for sinus in each region are participating in the model, in addition to multiple MA-PDs (see map).

The average premium in 2021 for the subset of enhanced PDPs participating in the insulin $35 copay model ($59) is nearly twice as high as the monthly premium for basic PDPs ($33) and 61% higher than the average premium for enhanced PDPs that are not participating in the model ($37) (weighted by September 2020 enrollment). Part D Cost SharingPart D Enrollees Will Pay Much Higher is zithromax effective for sinus Cost-Sharing Amounts for Brands and Non-preferred Drugs Than For Drugs on a Generic Tier, and a Mix of Copays and Coinsurance for Different Formulary TiersFigure 7. In 2021, Part D Enrollees Will Pay Much Higher Cost-Sharing Amounts for Brands and Non-preferred Drugs than for Drugs on a Generic Tier, and a Mix of Copays and Coinsurance for Different Formulary Tiers​In 2021, as in prior years, Part D enrollees will face much higher cost-sharing amounts for brands and non-preferred drugs (which can include both brands and generics) than for drugs on a generic tier, and a mix of copayments and coinsurance for different formulary tiers (Figure 7).

The typical five-tier formulary is zithromax effective for sinus design in Part D includes tiers for preferred generics, generics, preferred brands, non-preferred drugs, and specialty drugs. Among all PDPs, median standard cost sharing in 2021 is $0 for preferred generics and $5 for generics (an increase from $4 in 2020), $40 for preferred brands (a decrease from $42 in 2020), 40% coinsurance for non-preferred drugs (an increase from 38% in 2020. The maximum allowed is 50%), and 25% coinsurance for specialty is zithromax effective for sinus drugs (the same as in 2020.

The maximum allowed is 33%).Among the 21 national PDPs, 13 PDPs, covering 9.3 million enrollees as of September 2020, are increasing cost-sharing amounts for drugs on at least one formulary tier between 2020 and 2021 (Table 3). Five PDPs are increasing is zithromax effective for sinus copayments for generics, with increases ranging from $1 to $4. Six PDPs are increasing copayments for preferred brands, with increases ranging from $3 to $10.

And 10 PDPs are increasing coinsurance for non-preferred drugs, with increases ranging from 2 percentage points (e.g., from a 38% coinsurance rate to is zithromax effective for sinus 40%) to 14 percentage points (e.g., from a 35% coinsurance rate to 49%).Low-Income Subsidy Plan AvailabilityIn 2021, 259 Part D Stand-Alone Drug Plans Will Be Premium-Free to Enrollees Receiving the Low-Income Subsidy (Benchmark Plans)Figure 8. In 2021, 259 Part D Stand-Alone Drug Plans Will Be Available Without a Premium to Enrollees Receiving the Low-Income Subsidy (“Benchmark” Plans)​In 2021, a larger number of PDPs will be premium-free benchmark plans—that is, PDPs available for no monthly premium to Medicare Part D enrollees receiving the Low-Income Subsidy (LIS)—than in recent years, with 259 premium-free benchmark plans, or roughly a quarter of all PDPs in 2021 (Figure 8). Through the Part D LIS program, enrollees with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing.

As of 2020, approximately 13 million Part D enrollees are receiving LIS, including 6.7 million (52%) in PDPs and 6.1 million (48%) in MA-PDs.On average (weighted by Medicare enrollment), LIS beneficiaries have eight benchmark plans available to them for is zithromax effective for sinus 2021, or about one-fourth the average number of PDP choices available overall. All LIS enrollees can select any plan offered in their area, but if they enroll in a non-benchmark plan, they must pay some portion of their chosen plan’s monthly premium. In 2021, 10% of all LIS PDP enrollees who are eligible for premium-free Part D coverage (0.6 million LIS enrollees) will pay Part D premiums averaging $33 per month unless they switch or are reassigned by CMS to premium-free plans.The number of benchmark plans available is zithromax effective for sinus in 2021 will vary by region, from five to 10 (see map).

In 2020, 89% of the 6.6 million LIS PDP enrollees are projected to be in PDPs operated by five firms. CVS Health, Centene, is zithromax effective for sinus Humana, UnitedHealth, and Cigna (based on 2020 enrollment). DiscussionOur analysis of the Medicare Part D stand-alone drug plan landscape for 2021 shows that millions of Part D enrollees without low-income subsidies will face premium and other cost increases in 2021 if they stay in their current stand-alone drug plan.

There are more plans available nationwide in 2021, is zithromax effective for sinus with Medicare beneficiaries having 30 PDP choices during this year’s open enrollment period, plus 27 Medicare Advantage drug plan options. Most Part D PDP enrollees who remain in the same plan in 2021 will be in a plan with the standard $445 deductible and will face much higher cost sharing for brands than for generic drugs, including as much as 50% coinsurance for non-preferred drugs.Some Part D enrollees who choose to stay in their current plans may see lower premiums and other costs for their drug coverage, but nearly 8 in 10 non-LIS enrollees will face higher premiums if they remain in their current plan, and many will also face higher deductibles and cost sharing for covered drugs. Some beneficiaries might find the best coverage and costs for their specific medications in a plan with a relatively low premium, is zithromax effective for sinus while for other beneficiaries, a higher-premium plan might be more suitable.

Because Part D plans vary in a number of ways that can have a significant effect on an enrollee’s out-of-pocket spending, beyond the monthly premium, all Part D enrollees could benefit from the opportunity to compare plans during open enrollment.Juliette Cubanski is with KFF.Anthony Damico is an independent consultant. This analysis focuses on is zithromax effective for sinus the Medicare Part D stand-alone prescription drug plan marketplace in 2021 and trends over time. The analysis includes 20.2 million enrollees in stand-alone PDPs, as of March 2020.

The analysis excludes 17.4 million MA-PD enrollees (non-employer), and is zithromax effective for sinus another 4.6 million enrollees in employer-group only PDPs and 2.3 million in employer-group only MA-PDs for whom plan premium and benefits data are unavailable.Data on Part D plan availability, enrollment, and premiums were collected from a set of data files released by the Centers for Medicare &. Medicaid Services (CMS):– Part D plan landscape files, released each fall prior to the annual enrollment period– Part D plan and premium files, released each fall– Part D plan crosswalk files, released each fall– Part D contract/plan/state/county level enrollment files, released on a monthly basis– Part D Low-Income Subsidy enrollment files, released each spring– Medicare plan benefit package files, released each fallIn this analysis, premium estimates are weighted by September 2020 enrollment unless otherwise noted. Percentage increases are calculated based on non-rounded estimates and in some cases differ from percentage calculations calculated based on rounded estimates presented in the text..

Over the last decade, Medicare Advantage, the private plan alternative to traditional How do i get flagyl Medicare, has taken on a order zithromax z pak larger role in the Medicare program. In 2020, more than 24 million Medicare beneficiaries are enrolled in a Medicare Advantage plan. This brief provides an overview of the Medicare Advantage plans that are available for 2021 and order zithromax z pak key trends over time.Plan Offerings in 2021Number of PlansNumber of Plans Available to Beneficiaries. For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade (Figure 1).Figure 1.

The average Medicare beneficiary order zithromax z pak has access to 33 Medicare Advantage plans in 2021, an increase from prior yearsAmong the 33 Medicare Advantage plans generally available for individual enrollment to the average Medicare beneficiary, 27 of the plans include prescription drug coverage (MA-PDs). These numbers exclude employer or union-sponsored group plans, Special Needs Plans (SNPs) and PACE plans, which are only available to select populations.Total Number of Plans. In total, 3,550 Medicare Advantage plans are available nationwide for individual enrollment in 2021 – a 13 percent increase (402 more plans) from 2020 and the largest order zithromax z pak number of plans ever available (Figure 2. Appendix Table 1).

The vast majority order zithromax z pak (89 percent) of all Medicare Advantage plans offered include prescription drug coverage in 2021. .As in prior years, HMOs continue to account for about two-thirds (62%) of all plans offered in 2021. The availability of order zithromax z pak local PPOs has increased rapidly over recent years. In 2021, one-third of plans offered are local PPOs, compared to a quarter in 2018.

Between 2020 and 2021, the number of regional PPOs has remained constant, while the number of private fee-for-service plans has continued to decline.The growth in number of plans varies across states order zithromax z pak and counties, with the preponderance of the growth occurring in Florida and California (41 more and 30 more plans, respectively. Data not shown). Virginia has 6 fewer plans available for 2021 than in 2020, while South Carolina has 3 fewer plans, and Maryland and Nebraska each have one fewer plan available in 2021 than in 2020.While many employers and unions also offer Medicare Advantage plans to their retirees, no information about order zithromax z pak these 2021 plan offerings is made available by CMS to the public during the Medicare open enrollment period because these plans are not available to the general Medicare population.One notable change for 2021 is that people with end-stage renal disease (ESRD) are eligible to enroll in Medicare Advantage plans. Prior to this change, people with ESRD were not able to enroll in most Medicare Advantage plans, subject to limited exceptions, such as C-SNPS for people with ESRD.Special Needs Plans (SNPs).

More SNPs are available for 2021 than in any year since they were authorized, increasing from 855 plans in 2020 to 975 plans in 2021, a 14 percent increase (Figure 3). .The rise in SNPs for people who require an institutional-level of care (I-SNPs) has been particularly notable, more than doubling from 83 plans in 2017 to 174 plans in 2021 order zithromax z pak. I-SNPs may be attractive to insurers because they tend to have much lower marketing costs than other plan types since they are often the only available option for people to receive their Medicare benefits in certain retirement communities and nursing homes. The number of SNPs for people dually eligible for Medicare and Medicaid (D-SNPs) has also increased sharply over the past five years, rising from 373 dual SNPs in 2017 to 598 dual SNPs in 2021, a 60% increase, suggesting insurers’ continue to be interested in managing the care of this high-need population.The number of SNPs offered for people with chronic conditions (C-SNPs) is also increasing in 2021, most of which focus on people with diabetes, heart disease, or lung conditions, as has been the case order zithromax z pak since the inception of C-SNPs.

For 2021, three firms are offering C-SNPs for people with dementia (the same as 2020), two firms are offering a C-SNP for people with mental health conditions (up one from 2020), three firms are offering C-SNPs for people with end-stage renal disease (one fewer than 2020) and two firms are offering C-SNPs for people with HIV/AIDS (similar to 2020).Variation in the Number of Plans, by Geographic Area. On average, beneficiaries in metropolitan areas can choose from about twice as many Medicare Advantage plans as beneficiaries in non-metropolitan areas (36 plans versus 20 plans, respectively).In 11 percent order zithromax z pak of counties (accounting for 41% of beneficiaries), beneficiaries can choose from more than 35 plans in 2021, including eleven counties in Ohio and five counties in Pennsylvania where more than 60 Medicare Advantage plans are available (Figure 4). In contrast, in 4 percent of counties (accounting for 1% of beneficiaries), beneficiaries can choose from two or fewer Medicare Advantage plans. The number of counties with no Medicare Advantage plans for 2021 is 82, order zithromax z pak similar to 2020.

As in prior years, there are no Medicare Advantage plans offered in Alaska. Additionally, no Medicare Advantage plans are available in territories other order zithromax z pak than Puerto Rico. .Access to Medicare Advantage Plans, by Plan TypeAs in recent years, virtually all Medicare beneficiaries (99%) have access to a Medicare Advantage plan as an alternative to traditional Medicare, including almost all beneficiaries in metropolitan areas (99.9%) and the vast majority of beneficiaries in non-metropolitan areas (97.7%). In non-metropolitan counties, a smaller share of beneficiaries have access to HMOs (87% in non-metropolitan versus 99% in metropolitan counties) or local PPOs (89% in non-metropolitan versus 96% in metropolitan counties), and a slightly larger share of beneficiaries have access to regional PPOs (77% in non-metropolitan order zithromax z pak counties versus 72% in metropolitan counties).

Number of FirmsThe average Medicare beneficiary is able to choose from plans offered by 8 firms in 2021, one more than in 2020 (Figure 5). Despite most beneficiaries having access to plans operated by several different firms, enrollment is concentrated in plans operated by UnitedHealthcare, Humana, and Blue Cross order zithromax z pak Blue Shield affiliates.Figure 5. More than one-quarter of beneficiaries can choose among Medicare Advantage plans offered by 10 or more firmsMore than one-quarter of beneficiaries (27%) are able to choose from plans offered by 10 or more firms. Fifteen or more firms are offering Medicare Advantage plans in three counties.

Orange County, California and Summit and order zithromax z pak Medina Counties in Ohio. In contrast, in 109 counties, most of which are rural counties with relatively few Medicare beneficiaries (1% of total), only one firm will offer Medicare Advantage plans in 2021. Over the past several years, the number order zithromax z pak of counties with a single firm offering Medicare Advantage plans has fallen substantially. As recently as 2019, there was a single firm offering plans in nearly 200 counties.UnitedHealthcare and Humana, the two firms with the most Medicare Advantage enrollees in 2020, have large footprints across the country, offering plans in most counties.

Humana is offering plans order zithromax z pak in 84 percent of counties and UnitedHealthcare is offering plans in 66 percent of counties in 2021 (Figure 6). More than 8 in 10 (87%) Medicare beneficiaries have access to at least one Humana plan and 86 percent have access to at least one UnitedHealthcare plans. .Most major order zithromax z pak Medicare Advantage firms have also expanded the number of counties where they are offering plans. UnitedHealthcare is offering plans in 2,117 counties in 2021, an increase of 245 from 2021, while Humana is offering plans in 2,703 counties in 2021, an increase of 33 from 2020.

Centene is offering plans in 1,129 counties in order zithromax z pak 2021, an increase of 261 plans from 2020. Blue Cross Blue Shield Affiliates are offering plans in 1,181 counties, an increase of 152 plans. CVS Health is order zithromax z pak offering plans in 1,759 counties, an increase of 119 plans. And Cigna is offering plans in 369 counties, an increase of 67 plans.

Kaiser Permanente had the smallest growth and is offering plans in 109 counties, an order zithromax z pak increase of 4 plans.New Market Entrants and ExitsMedicare Advantage continues to be an attractive market for insurers, with 14 firms entering the market for the first time in 2021, collectively accounting for about 6 percent of the growth in the number of plans available for general enrollment and about 10 percent of the growth in SNPs (Appendix Table 2). Nine new entrants are offering HMOs available for individual enrollment. Five of the new entrants are order zithromax z pak offering SNPs. Three firms are offering D-SNPs for people dually eligible for Medicaid, three firms are offering C-SNPs for people with select chronic conditions, and one firm is offering an I-SNPs Four of the new firm entrants are offering plans in California, two are offering plans in Indiana, and the remainder are offering plans in at least one of ten other states (Colorado, Georgia, Illinois, Mississippi, Missouri, Ohio, Texas, Utah, and Wisconsin).Six firms that previously participated in the Medicare Advantage market are not offering plans in 2021.

Two of the firms (ApexHealth, Inc. And Clarion Health) offered plans for the order zithromax z pak first time in 2020, but did not appear to enroll any participants. The other four firms had very low enrollment in 2020. Three of the six exiting firms offered plans order zithromax z pak in New York.PremiumsThe vast majority of Medicare Advantage plans for individual enrollment (89%) will include prescription drug coverage (MA-PDs), and 54 percent of these plans will charge no premium, other than the Part B premium, similar to 2020.

More than nine out of ten beneficiaries (96%) have access to a MA-PD with no monthly premium in 2021. However, in Wyoming, beneficiaries do not have access to a zero-premium MA-PD, and in Idaho, less order zithromax z pak than half of beneficiaries have access to a zero-premium MA-PD.In 2020, 60 percent of enrollees in MA-PD plans pay no premium other than the Medicare Part B premium of $144.60 per month. Based on enrollment in March 2020, nearly one in five enrollees (18%) pay at least $50 a month, and 6 percent pay $100 or more. CMS announced that the average monthly plan premium among all Medicare Advantage enrollees in 2021, including those who pay no premium for their Medicare Advantage plan, is expected to decrease 11 percent from order zithromax z pak 2020 to $21 a month.

CMS does not disclose the methods or assumptions used in deriving their calculations, but since most Medicare Advantage enrollees pay no additional premium, the average they report is heavily influenced by zero-premium plans, and does not reflect the average premium paid by those who are in plans with an additional premium.Extra BenefitsMedicare Advantage plans may provide extra benefits that are not available in traditional Medicare, are considered “primarily health related,” and can use rebate dollars (including bonus payments) to help cover the cost of these extra benefits. Beginning in 2019, CMS expanded the definition of “primarily health related” order zithromax z pak to allow Medicare Advantage plans to offer additional supplemental benefits. Medicare Advantage plans may also restrict the availability of these extra benefits to certain subgroups of beneficiaries, such as those with diabetes or congestive heart failure, making different benefits available to different enrollees.Beginning in 2020, Medicare Advantage plans have also been able to offer extra benefits that are not primarily health related for chronically ill beneficiaries, known as Special Supplemental Benefits for the Chronically Ill (SSBCI). Information on the order zithromax z pak availability of SSBCI for 2021 has not yet been published by CMS, but may include services such as pest control, food and produce (beyond a limited basis), and non-medical transportation.

Since plans are permitted to offer these benefits non-uniformly to enrollees, it will be important to examine how these benefits are distributed across subgroups of enrollees.Availability of Extra Benefits in Plans for General Enrollment. Historically, the most offered extra benefits were fitness, dental, vision, order zithromax z pak and hearing. Nearly two-thirds of plans (68%) provide all four of these benefits for 2021. Though these benefits are widely available, the scope of specific services varies.

For example, a dental benefit may order zithromax z pak include cleanings only or more comprehensive coverage. As of 2020, Medicare Advantage plans have also been allowed to offer more telehealth benefits than traditional Medicare (though Medicare has temporarily expanded these benefits during the zithromax). The vast majority (98%) of Medicare order zithromax z pak Advantage plans are offering telehealth in 2021 (up from 91% in 2020) (Figure 7).Figure 7. Most Medicare Advantage plans provide fitness and dental benefits but much fewer provide in-home or caregiver supportOther extra benefits that are frequently offered for 2021 include over the counter items (75%), meal benefits, such as a cooking class, nutrition education, or meal delivery (55%), and transportation benefits (36%).Less than 10 percent of plans provide bathroom safety devices (6%) or in-home support (6%).Availability of Extra Benefits in Special Needs Plans.

SNPs are designed to serve a disproportionately high-need population, and a somewhat larger percentage of SNPs than plans for other Medicare beneficiaries provide their enrollees with over the counter items (91%), transportation order zithromax z pak benefits (85%) and meal benefits (63%). Similar to plans available for general enrollment, a relatively small share of SNPs provide bathroom safety devices (11%) or in-home support (18%).Access to Extra Benefits. Virtually all Medicare beneficiaries live in a county where at least one Medicare Advantage plan available for general enrollment has some extra benefits not covered by traditional Medicare, with 98% having access to some dental, fitness, vision, order zithromax z pak and hearing benefits for 2021. The vast majority of beneficiaries also have access to telehealth benefits (99%), over the counter items (99%), transportation assistance (95%) and a meal benefit (98%), but far fewer have access to bathroom safety (55%) or in-home support (62%).DiscussionMore Medicare Advantage plans are being offered for 2021 than in any other year.

Fourteen insurers order zithromax z pak are entering the Medicare Advantage market for the first time, and six insurers are exiting the market, suggesting thatMedicare Advantage remains an attractive, profitable market for insurers. As in prior years, some (mostly non-metropolitan) counties are less attractive to insurers, with fewer firms and plans available, though the number of areas where this is the case has declined over time. Overall, more than 99 order zithromax z pak percent of beneficiaries will have access to one or more Medicare Advantage plans in 2021, similar to prior years. With more firms offering SNPs and the number of SNPs rapidly growing, there may be greater focus on how well high-need, vulnerable beneficiaries are being served by Medicare Advantage plans, including SNPs as well as plans for general enrollment.

As Medicare Advantage enrollment continues order zithromax z pak to grow, insurers seem to be responding by offering more plans and choices to the people on Medicare. This analysis focuses on the Medicare Advantage marketplace in 2021 and trends over time. The analysis includes more than 24 million enrollees in Medicare Advantage plans in 2020.Data on Medicare Advantage plan availability, enrollment, and premiums were collected from a set of data files released by the Centers for Medicare &. Medicaid Services (CMS):Medicare Advantage plan landscape files, released each fall prior to the annual enrollment periodMedicare Advantage plan and premium files, released each fallMedicare Advantage plan crosswalk files, released each fallMedicare Advantage contract/plan/state/county level enrollment files, released on a monthly basisMedicare Advantage plan benefit package files, released each fallMedicare Enrollment Dashboard files, released on a monthly basisIn previous years, KFF has order zithromax z pak used the Medicare Advantage Penetration Files to calculate the number of Medicare beneficiaries eligible for Medicare.

The Medicare Advantage Penetration Files includes people who were previously, but no longer covered by Medicare (e.g., people who obtained employer-sponsored health insurance coverage after initially enrolling in Medicare). It also order zithromax z pak includes people within 5 months of their 65th birthday, but not yet age 65. In addition, CMS has identified an issue where beneficiaries with multiple addresses were double counted in the Penetration File. KFF has order zithromax z pak refined its approach this year and is using the Medicare Enrollment Dashboard to calculate the number of Medicare beneficiaries because it only includes Medicare beneficiaries with either Part A or Part B coverage, which is a more accurate estimate of the Medicare population.

The numbers published here supersede all prior estimates by KFF of the number of Medicare beneficiaries.Jeannie Fuglesten Biniek, Meredith Freed, and Tricia Neuman are with KFF.Anthony Damico is an independent consultant.During the Medicare open enrollment period from October 15 to December 7 each year, beneficiaries can enroll in a plan that provides Part D drug coverage, either a stand-alone prescription drug plan (PDP) as a supplement to traditional Medicare, or a Medicare Advantage prescription drug plan (MA-PD), which covers all Medicare benefits, including drugs. Among the 46 million Part D enrollees order zithromax z pak in 2020, 20.2 million (44%) are in PDPs and 19.3 million (41%) are in MA-PDs (excluding the 7.0 million (15%) in employer-only group PDPs and MA-PDs). This issue brief provides an overview of Medicare Part D drug plans that will be available in 2021 and key trends over time.Part D Plan AvailabilityThe Average Medicare Beneficiary Has a Choice of Nearly 60 Medicare Plans with Part D Drug Coverage in 2021, Including 30 Medicare Stand-alone Drug Plans and 27 Medicare Advantage Drug PlansFigure 1. The Average Medicare Beneficiary Has a Choice of Nearly 60 Medicare Plans Offering Drug Coverage in 2021, Including 30 Stand-alone Drug Plans and 27 Medicare Advantage Drug PlansA larger number of Part D plans will be offered in 2021 order zithromax z pak than in recent years.

The average Medicare beneficiary will have a choice of 30 stand-alone PDPs in 2021, two more PDP options than in 2020, and eight more than in 2017, a 36% increase (Figure 1). Although the number of PDP options in 2021 is half of what it was at the peak in 2007 (when there were 56 PDP options, on average), this is the fourth year in a row with an increase in the average number of stand-alone drug plan options.In 2021, beneficiaries will order zithromax z pak also have access to 27 MA-PDs, on average, a 71% increase in MA-PD options since 2017 (excluding Medicare Advantage plans that do not offer the drug benefit and plans not available to all beneficiaries. Overall, an average of 33 Medicare Advantage plan options will be available in 2021).Based on September 2020 enrollment, 8 out of 10 PDP enrollees (80%) in 2021 are projected to be in PDPs operated by just four firms. UnitedHealth, Centene (which acquired WellCare in 2020), order zithromax z pak Humana, and CVS Health (based on PDP enrollment as of September 2020).

All four firms offer PDPs in all 34 PDP regions in 2021.A Total of 996 Medicare Part D Stand-Alone Prescription Drug Plans Will Be Offered in 2021, a 5% Increase From 2020 and a 34% Increase Since 2017 Figure 2. A Total of 996 Medicare Part D Stand-Alone Prescription Drug Plans Will Be Offered in 2021, a 5% Increase From 2020 and a 34% Increase Since 2017​A total of 996 PDPs will be offered in the 34 PDP regions in 2021 (plus another 11 PDPs in the territories), an increase of 48 PDPs (5%) over 2020, and 250 more PDPs (a 34% increase) since 2017 (Figure 2). This increase is primarily due to the Trump Administration’s elimination of the “meaningful order zithromax z pak difference” requirement for enhanced benefit PDPs offered by the same organization in the same region. Eliminating this requirement means that PDP sponsors no longer have to demonstrate that their enhanced PDPs offered in the same region are meaningfully different in terms of enrollee out-of-pocket costs.

In 2021, 62% of PDPs (618 plans) will offer enhanced Part D benefits—a 60% increase in the availability of enhanced-benefit PDPs since 2017, when just over half of PDPs (387 plans) offered enhanced benefits.The number of PDPs per region in 2021 will range from 25 PDPs in Alaska to 35 PDPs order zithromax z pak in Texas and will be the same or higher in 32 of the 34 PDP regions compared to 2020 (see map, Table 1). Part D PremiumsThe Estimated Average Monthly Premium for Medicare PDPs Is Projected to Increase by 9% to $41 in 2021, Based on Current EnrollmentFigure 3. The Estimated Average Monthly Premium for Medicare PDPs Is Projected to Increase by 9% to $41 in 2021, Based on Current Enrollment​The estimated national average monthly PDP premium for order zithromax z pak 2021 is projected to increase by 9% to $41, from $38 in 2021, weighted by September 2020 enrollment (Figure 3). It is likely that the actual average weighted premium for 2021, after taking into account enrollment choices by new enrollees and plan changes by current enrollees, will be somewhat lower than the estimated average.

CMS reported that the average premium for basic Part D coverage offered by PDPs and MA-PDs will be order zithromax z pak an estimated $30 in 2021. Our premium estimate is higher because it is based on PDPs only (excluding MA-PDs) and includes PDPs offering both basic and enhanced coverage (enhanced plans, which account for 62% of all PDPs in 2021, have higher premiums than basic plans, on average).Average Monthly Premiums for the 21 National Part D Stand-alone PDPs Are Projected to Range from $7 to $89 in 2021, with Higher Average Premiums for Enhanced Benefits and Zero-Deductible PDPsFigure 4. Average Monthly Premiums for the 21 National Part D Stand-alone Drug Plans Are Projected to Range from $7 to $89 in 2021​PDP premiums will vary widely across plans in 2021, as in previous order zithromax z pak years (Figure 4, Table 2). Among the 21 PDPs available nationwide, average premiums will range from a low of $7 per month for SilverScript SmartRx to a high of $89 per month for AARP MedicareRx Preferred.Changes to premiums from 2020 to 2021, averaged across regions and weighted by 2020 enrollment, also vary widely across PDPs, as do the absolute amounts of monthly premiums for 2021.The 1.9 million non-LIS enrollees in the largest PDP, CVS Health’s SilverScript Choice (which had a total of 3.9 million enrollees in 2020, including those receiving low-income subsidies) will face a modest $1 (2%) decrease in their average monthly premium, from $29 in 2020 to $28 in 2021.In contrast, the 1.8 million non-LIS enrollees in the second largest PDP, AARP MedicareRx Preferred, will face a $10 (12%) increase in their average monthly premium between 2020 and 2021, from $79 to $89.

This is the highest monthly premium among the national PDPs in 2021.The 1.3 million non-LIS enrollees in the fourth largest PDP, Humana Premier Rx, will see a $7 (13%) increase in their monthly premium, from $58 order zithromax z pak in 2020 to $65 in 2021.Most Part D stand-alone drug plans in 2021 (62% of PDPs) will offer enhanced benefits for a higher monthly premium. Enhanced benefits can include a lower (or no) deductible, reduced cost sharing, or a higher initial coverage limit than under the standard benefit design. The average premium in 2021 for enhanced benefit PDPs is $51, which is 55% order zithromax z pak higher than the monthly premium for PDPs offering the basic benefit ($33) (weighted by September 2020 enrollment).In 2021, a large majority of PDPs (86%) will charge a deductible, with most PDPs (67%) charging the standard amount of $445 in 2021. Across all PDPs, the average deductible in 2021 will be $345 (weighted by September 2020 enrollment).

The average monthly premium in order zithromax z pak 2021 for PDPs that charge no deductible is $88, nearly three times the monthly premium for PDPs that charge the standard deductible ($34) or a partial deductible ($31) (weighted by September 2020 enrollment).Nearly 8 in 10 Part D Stand-alone Drug Plan Enrollees Without Low-income Subsidies Will Pay Higher Premiums in 2021 If They Stay in Their Current PlanFigure 5. Nearly 8 in 10 Part D Stand-alone Drug Plan Enrollees Without Low-income Subsidies Will Pay Higher Premiums in 2021 If They Stay in Their Current Plan​Most (78%, or 10 million) of the 13.4 million Part D PDP enrollees who are responsible for paying the entire premium (which excludes Low-Income Subsidy (LIS) recipients) will see their monthly premium increase in 2021 if they stay in their same plan, while 2.8 million (21%) will see a premium reduction if they stay in their same plan (Figure 5).Nearly 2 million non-LIS enrollees (13%) will see a premium increase of $10 or more per month, while significantly fewer (0.2 million non-LIS enrollees, or 1%) will see a premium reduction of the same magnitude. One-third (34%) of non-LIS enrollees (4.6 million) are projected to pay monthly premiums of at least $60 if they stay in their current plans, and more than 230,000 (2% of non-LIS enrollees) are projected to pay monthly premiums of at least $100.The Average Monthly Part D Premium in 2021 for the Subset of Enhanced Stand-alone Drug Plans Covering Insulin at a $35 Monthly Copay Is Substantially Higher Than Premiums for Other PDPsFigure 6. The Average Monthly Part D Premium in 2021 for the Subset of Enhanced Stand-alone Drug Plans Covering Insulin at a $35 Monthly Copay is Substantially Higher than Premiums for Other Plans​New for 2021, beneficiaries in each state will have the option to enroll in a Part D plan participating in the Trump Administration’s new Innovation Center model in which enhanced drug plans cover insulin products order zithromax z pak at a monthly copayment of $35 in the deductible, initial coverage, and coverage gap phases of the Part D benefit.

Participating plans do not have to cover all insulin products at the $35 monthly copayment amount, just one of each dosage form (vial, pen) and insulin type (rapid-acting, short-acting, intermediate-acting, and long-acting).In 2021, a total of 1,635 enhanced Part D plans will participate in this model, which represents just over 30% of both PDPs (310 plans) and MA-PDs (1,325 plans) available in 2021, including plans in the territories. Between 8 and 10 enhanced PDPs in each region are participating in the model, in addition to multiple MA-PDs (see map) order zithromax z pak. The average premium in 2021 for the subset of enhanced PDPs participating in the insulin $35 copay model ($59) is nearly twice as high as the monthly premium for basic PDPs ($33) and 61% higher than the average premium for enhanced PDPs that are not participating in the model ($37) (weighted by September 2020 enrollment). Part D Cost SharingPart D Enrollees Will Pay Much Higher Cost-Sharing Amounts for Brands and Non-preferred order zithromax z pak Drugs Than For Drugs on a Generic Tier, and a Mix of Copays and Coinsurance for Different Formulary TiersFigure 7.

In 2021, Part D Enrollees Will Pay Much Higher Cost-Sharing Amounts for Brands and Non-preferred Drugs than for Drugs on a Generic Tier, and a Mix of Copays and Coinsurance for Different Formulary Tiers​In 2021, as in prior years, Part D enrollees will face much higher cost-sharing amounts for brands and non-preferred drugs (which can include both brands and generics) than for drugs on a generic tier, and a mix of copayments and coinsurance for different formulary tiers (Figure 7). The typical five-tier formulary design in Part D includes tiers for preferred generics, generics, preferred brands, non-preferred drugs, and specialty order zithromax z pak drugs. Among all PDPs, median standard cost sharing in 2021 is $0 for preferred generics and $5 for generics (an increase from $4 in 2020), $40 for preferred brands (a decrease from $42 in 2020), 40% coinsurance for non-preferred drugs (an increase from 38% in 2020. The maximum allowed is 50%), order zithromax z pak and 25% coinsurance for specialty drugs (the same as in 2020.

The maximum allowed is 33%).Among the 21 national PDPs, 13 PDPs, covering 9.3 million enrollees as of September 2020, are increasing cost-sharing amounts for drugs on at least one formulary tier between 2020 and 2021 (Table 3). Five PDPs are increasing order zithromax z pak copayments for generics, with increases ranging from $1 to $4. Six PDPs are increasing copayments for preferred brands, with increases ranging from $3 to $10. And 10 PDPs are increasing coinsurance for non-preferred drugs, with increases ranging from 2 percentage points (e.g., from a 38% coinsurance rate to 40%) to 14 order zithromax z pak percentage points (e.g., from a 35% coinsurance rate to 49%).Low-Income Subsidy Plan AvailabilityIn 2021, 259 Part D Stand-Alone Drug Plans Will Be Premium-Free to Enrollees Receiving the Low-Income Subsidy (Benchmark Plans)Figure 8.

In 2021, 259 Part D Stand-Alone Drug Plans Will Be Available Without a Premium to Enrollees Receiving the Low-Income Subsidy (“Benchmark” Plans)​In 2021, a larger number of PDPs will be premium-free benchmark plans—that is, PDPs available for no monthly premium to Medicare Part D enrollees receiving the Low-Income Subsidy (LIS)—than in recent years, with 259 premium-free benchmark plans, or roughly a quarter of all PDPs in 2021 (Figure 8). Through the Part D LIS program, enrollees with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. As of 2020, approximately 13 million Part D enrollees are receiving LIS, including 6.7 million (52%) in PDPs and order zithromax z pak 6.1 million (48%) in MA-PDs.On average (weighted by Medicare enrollment), LIS beneficiaries have eight benchmark plans available to them for 2021, or about one-fourth the average number of PDP choices available overall. All LIS enrollees can select any plan offered in their area, but if they enroll in a non-benchmark plan, they must pay some portion of their chosen plan’s monthly premium.

In 2021, 10% of all LIS order zithromax z pak PDP enrollees who are eligible for premium-free Part D coverage (0.6 million LIS enrollees) will pay Part D premiums averaging $33 per month unless they switch or are reassigned by CMS to premium-free plans.The number of benchmark plans available in 2021 will vary by region, from five to 10 (see map). In 2020, 89% of the 6.6 million LIS PDP enrollees are projected to be in PDPs operated by five firms. CVS Health, Centene, Humana, UnitedHealth, and Cigna (based on 2020 order zithromax z pak enrollment). DiscussionOur analysis of the Medicare Part D stand-alone drug plan landscape for 2021 shows that millions of Part D enrollees without low-income subsidies will face premium and other cost increases in 2021 if they stay in their current stand-alone drug plan.

There are more plans available nationwide in 2021, with Medicare beneficiaries having 30 PDP choices during this year’s order zithromax z pak open enrollment period, plus 27 Medicare Advantage drug plan options. Most Part D PDP enrollees who remain in the same plan in 2021 will be in a plan with the standard $445 deductible and will face much higher cost sharing for brands than for generic drugs, including as much as 50% coinsurance for non-preferred drugs.Some Part D enrollees who choose to stay in their current plans may see lower premiums and other costs for their drug coverage, but nearly 8 in 10 non-LIS enrollees will face higher premiums if they remain in their current plan, and many will also face higher deductibles and cost sharing for covered drugs. Some beneficiaries might find the best coverage and costs for their specific medications in a plan with a relatively low premium, while for other beneficiaries, a higher-premium plan might be order zithromax z pak more suitable. Because Part D plans vary in a number of ways that can have a significant effect on an enrollee’s out-of-pocket spending, beyond the monthly premium, all Part D enrollees could benefit from the opportunity to compare plans during open enrollment.Juliette Cubanski is with KFF.Anthony Damico is an independent consultant.

This analysis focuses on the Medicare Part D stand-alone prescription drug plan marketplace in 2021 order zithromax z pak and trends over time. The analysis includes 20.2 million enrollees in stand-alone PDPs, as of March 2020. The analysis excludes 17.4 million MA-PD enrollees (non-employer), and another 4.6 million enrollees in employer-group only PDPs and 2.3 million in employer-group only MA-PDs for whom plan premium and benefits data are unavailable.Data on Part D plan availability, enrollment, order zithromax z pak and premiums were collected from a set of data files released by the Centers for Medicare &. Medicaid Services (CMS):– Part D plan landscape files, released each fall prior to the annual enrollment period– Part D plan and premium files, released each fall– Part D plan crosswalk files, released each fall– Part D contract/plan/state/county level enrollment files, released on a monthly basis– Part D Low-Income Subsidy enrollment files, released each spring– Medicare plan benefit package files, released each fallIn this analysis, premium estimates are weighted by September 2020 enrollment unless otherwise noted.

Percentage increases are calculated based on non-rounded estimates and in some cases differ from percentage calculations calculated based on rounded estimates presented in the text..

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I was fortunate to call zithromax otc alternative ODEP home for a significant portion of my earlier career, and returning during the agency’s 20th anniversary year is especially gratifying. Like our nation at large, ODEP is at a historic crossroads, and it’s with this in mind that I’ve been extensively exploring our work. We cover a wide range of issues, from employer policy to youth transition to accessible technology, to name just a few. We’ve also been responsive to new issues as they arise, including those zithromax otc alternative created by the buy antibiotics zithromax.

Looking ahead, we know we must also do more to ensure our work to promote disability inclusion is, in fact, fully inclusive and equitable. To this end, we are closely examining our policy and programmatic efforts to ensure they meet the needs of all people with disabilities, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality. As diverse and far-reaching as our work is, the zithromax otc alternative thread tying it all together is the ever-important goal of changing attitudes and behavior. National Disability Employment Awareness Month, held each October, is an annual reaffirmation of this common goal, and this year’s theme – America’s Recovery.

Powered by Inclusion – speaks to the critical role Americans with disabilities, from all backgrounds, play in our economic success. Indeed, our economic recovery will be driven by resourcefulness zithromax otc alternative and resilience, attributes often strengthened by virtue of experience with disability. ODEP leads NDEAM at the national level while also supporting and encouraging individuals and organizations across the country to celebrate locally. And celebrate they do!.

Every year, we are wowed by the many creative ways people channel the spirit of NDEAM into their own activities, which have included everything from a small business hosting a staff lunch-and-learn about disability employment to a major television network framing their October programming around zithromax otc alternative the issue. Whether large or small, NDEAM activities help highlight the value and talent people with disabilities add to America’s workplaces and economy, a goal that is shared by the Campaign for Disability Employment, which extends the month’s spirit throughout the year. The CDE started in 2009, when ODEP charged a group of leading disability and business organizations to spread positive media messages about the value and talent that people with disabilities bring to America’s workplaces. The result was an zithromax otc alternative integrated public education initiative centered on a series of award-winning television and radio PSAs.

These PSAs, which have now aired more than 450,000 times on television and radio stations nationwide, can all be accessed on the CDE website, along with other tools and ideas for supporting the campaign. The CDE’s core message - that at work, it’s what people CAN do that matters - captures the essence of ODEP’s efforts to challenge misconceptions about and highlight the contributions of America’s workers with disabilities. NDEAM, the CDE and our other zithromax otc alternative awareness-building activities are important complements to ODEP’s policy work, helping illustrate, through positive imagery and stories, the importance of our work to advance disability equity and inclusion, every day of every month. Visit dol.gov/ndeam to join us in celebrating America’s workers with disabilities, and their critical goal in powering a complete and inclusive recovery.

Taryn M. Williams is the assistant secretary of labor for disability zithromax otc alternative employment policy.This year marks 20 years since the department’s Office of Disability Employment Policy, or ODEP, was created. In honor of this milestone, ODEP Deputy Assistant Secretary Jennifer Sheehy recently talked to Dr. Roy Grizzard, who served as ODEP’s assistant secretary from 2002 to 2007.

Sheehy. Please tell us about your career prior to coming to ODEP, and how you ended up the first assistant secretary. Grizzard. I spent 27 years working for Henrico County Public Schools in Virginia, first as an educator and coach and later as an administrator.

I then served for six years as commissioner of the Virginia Department for the Blind and Vision Impaired. That’s where I was when I came to D.C. And ODEP. I actually found out I was being considered for the position when I was down at the Virginia Leadership Institute, which is a training program for state department heads.

I came back to my hotel room one night and found the message light on my phone blinking. It was my wife, who said “the White House just called and wants you to call them back.” So, that’s what I did, and I learned that the former Virginia Secretary of Health and Human Services, who was then Deputy Secretary at the federal HHS, had put my name forward for the position. I was eventually confirmed on July 26, 2002, the 12th anniversary of the Americans with Disabilities Act. Sheehy.

What was it like in the early days, building a new agency from the ground up?. Grizzard. It was a very stimulating and exciting time, not just for me, but really everyone involved. To start, we brought on the talented folks from the President’s Committee on Employment of People with Disabilities and the Presidential Task Force on Employment of Adults with Disabilities.

Then we brought on, as we could, new people who had expertise in certain areas, and it was fun to watch the bonding involved in putting forth a new agency. It was very rewarding and, I hope, a positive experience for everybody there at the time. Sheehy. What are you most proud of from your time at ODEP?.

Grizzard. Well, several things, but most were initiated by someone else. I was just a catalyst for getting things done. We had some very intelligent people from a variety of backgrounds, and they merged into a great team.

One thing that sticks out is the grants, because they could be very impactful by demonstrating strategies for replication. I was invested in the “High School/High Tech” grants, partly because of my background in education. I was also proud of our grants on combating homelessness through not only housing, but also employment. We worked with the U.S.

Department of Housing and Urban Development and the department’s Veterans’ Employment and Training Service, recognizing that many people who are homeless are veterans and/or have some form of disability, whether obvious or not. Another thing that comes to mind is our work on workplace emergency preparedness for people with disabilities. This was not long after 9/11, and we helped create a guide that had applicability not just in the workplace, but also homes and other facilities. Sheehy.

What is something that you feel might not have been possible without the existence of ODEP?. Grizzard. For certain, one big thing was data — adding questions to get accurate data on disability and employment through the Current Population Survey. This had not been done before, and it’s so important to shaping good public policy.

We initiated that process, and it took years, because there were many layers of review needed to make sure we got it right, but now that data exists and is updated monthly. Sheehy. The workplace has changed dramatically since ODEP was established. What can we do to include more people with disabilities as it continues to change?.

Grizzard. Well, something I’ve been thinking a lot about lately is the effect of so many people telecommuting.

We’ve also been responsive to new issues as they order zithromax z pak arise, including those created by the buy antibiotics zithromax. Looking ahead, we know we must also do more to ensure our work to promote disability inclusion is, in fact, fully inclusive and equitable. To this end, we are closely examining our policy and programmatic efforts to ensure they meet the needs of all people with disabilities, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality. As diverse and far-reaching as our work is, the thread tying it all order zithromax z pak together is the ever-important goal of changing attitudes and behavior.

National Disability Employment Awareness Month, held each October, is an annual reaffirmation of this common goal, and this year’s theme – America’s Recovery. Powered by Inclusion – speaks to the critical role Americans with disabilities, from all backgrounds, play in our economic success. Indeed, our economic recovery will be driven by resourcefulness and resilience, attributes often strengthened by virtue of order zithromax z pak experience with disability. ODEP leads NDEAM at the national level while also supporting and encouraging individuals and organizations across the country to celebrate locally.

And celebrate they do!. Every year, we are wowed by order zithromax z pak the many creative ways people channel the spirit of NDEAM into their own activities, which have included everything from a small business hosting a staff lunch-and-learn about disability employment to a major television network framing their October programming around the issue. Whether large or small, NDEAM activities help highlight the value and talent people with disabilities add to America’s workplaces and economy, a goal that is shared by the Campaign for Disability Employment, which extends the month’s spirit throughout the year. The CDE started in 2009, when ODEP charged a group of leading disability and business organizations to spread positive media messages about the value and talent that people with disabilities bring to America’s workplaces.

The result was an integrated public education initiative centered order zithromax z pak on a series of award-winning television and radio PSAs. These PSAs, which have now aired more than 450,000 times on television and radio stations nationwide, can all be accessed on the CDE website, along with other tools and ideas for supporting the campaign. The CDE’s core message - that at work, it’s what people CAN do that matters - captures the essence of ODEP’s efforts to challenge misconceptions about and highlight the contributions of America’s workers with disabilities. NDEAM, the CDE and our other awareness-building activities are important complements to ODEP’s policy work, helping order zithromax z pak illustrate, through positive imagery and stories, the importance of our work to advance disability equity and inclusion, every day of every month.

Visit dol.gov/ndeam to join us in celebrating America’s workers with disabilities, and their critical goal in powering a complete and inclusive recovery. Taryn M. Williams is order zithromax z pak the assistant secretary of labor for disability employment policy.This year marks 20 years since the department’s Office of Disability Employment Policy, or ODEP, was created. In honor of this milestone, ODEP Deputy Assistant Secretary Jennifer Sheehy recently talked to Dr.

Roy Grizzard, who served as ODEP’s assistant secretary from 2002 to 2007. Sheehy. Please tell us about your career prior to coming to ODEP, and how you ended up the first assistant secretary. Grizzard.

I spent 27 years working for Henrico County Public Schools in Virginia, first as an educator and coach and later as an administrator. I then served for six years as commissioner of the Virginia Department for the Blind and Vision Impaired. That’s where I was when I came to D.C. And ODEP.

I actually found out I was being considered for the position when I was down at the Virginia Leadership Institute, which is a training program for state department heads. I came back to my hotel room one night and found the message light on my phone blinking. It was my wife, who said “the White House just called and wants you to call them back.” So, that’s what I did, and I learned that the former Virginia Secretary of Health and Human Services, who was then Deputy Secretary at the federal HHS, had put my name forward for the position. I was eventually confirmed on July 26, 2002, the 12th anniversary of the Americans with Disabilities Act.

Sheehy. What was it like in the early days, building a new agency from the ground up?. Grizzard. It was a very stimulating and exciting time, not just for me, but really everyone involved.

To start, we brought on the talented folks from the President’s Committee on Employment of People with Disabilities and the Presidential Task Force on Employment of Adults with Disabilities. Then we brought on, as we could, new people who had expertise in certain areas, and it was fun to watch the bonding involved in putting forth a new agency. It was very rewarding and, I hope, a positive experience for everybody there at the time. Sheehy.

What are you most proud of from your time at ODEP?. Grizzard. Well, several things, but most were initiated by someone else. I was just a catalyst for getting things done.

We had some very intelligent people from a variety of backgrounds, and they merged into a great team. One thing that sticks out is the grants, because they could be very impactful by demonstrating strategies for replication. I was invested in the “High School/High Tech” grants, partly because of my background in education. I was also proud of our grants on combating homelessness through not only housing, but also employment.

We worked with the U.S. Department of Housing and Urban Development and the department’s Veterans’ Employment and Training Service, recognizing that many people who are homeless are veterans and/or have some form of disability, whether obvious or not. Another thing that comes to mind is our work on workplace emergency preparedness for people with disabilities. This was not long after 9/11, and we helped create a guide that had applicability not just in the workplace, but also homes and other facilities.

Sheehy. What is something that you feel might not have been possible without the existence of ODEP?. Grizzard. For certain, one big thing was data — adding questions to get accurate data on disability and employment through the Current Population Survey.

This had not been done before, and it’s so important to shaping good public policy. We initiated that process, and it took years, because there were many layers of review needed to make sure we got it right, but now that data exists and is updated monthly. Sheehy. The workplace has changed dramatically since ODEP was established.

What can we do to include more people with disabilities as it continues to change?. Grizzard. Well, something I’ve been thinking a lot about lately is the effect of so many people telecommuting. I think that can open a lot of doors.

Of course, this isn’t necessarily for all people, or even all people with disabilities. No two people with disabilities have the same needs, even if they have the same nature of disability.