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PDP-Compare Tutorial
This tutorial explains how to search and compare Medicare Part D plans using PDP-Compare.
:: One-Click Comparison
:: PDP-Compare Search Criteria
:: Example 1: Changes in Current Plan
:: Example 2: 2007 Plan no longer offered in 2008
:: Example 3: Change in Plan Coverage from 2007 to 2008
:: Example 4: Advanced Search - Comparing Plans from Different Companies.
:: Example 5: Advanced Search - Premium increases in California
:: Chart Key: What do all of the Chart Fields Mean?
One-Click Comparison
PDP-Compare offers what we call a One-Click Comparison of Medicare Part D Plans.
By simply selecting your state and clicking on the Search button, you can compare:
- Plan Quality Ratings,
- Premium,
- Deductible,
- Type of Coverage during the Doughnut Hole,
- $0 Qualification for Low-Income Subsidy (LIS) Recipients
- Cost Sharing - Copayments, Co-insurance, and
- Popularity (Past Enrollment Figures)
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:: Go to PDP-Compare. Select your state and click Search for a One-Click Comparison
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PDP-Compare Search Criteria
Each State offers 50 or more Medicare Part D plans. Sometimes it helps to reduce the number of plans that you want to compare. This section explains the search and sort options in PDP-Compare.
The Search Criteria are divided into three areas:
- Those applying to the plan independent of the plan year
- Criteria to be used against the 2007 plans
- Criteria to be used against the 2008 plans
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Criteria that are used independent of the plan year include:
- State - this is a required field. You must select a state.
- Partial Plan Name - If you are only interested in certain plans, ex: AARP, enter the any part of the plan name in this field examples: AA or AARP, AR would not only include the AARP plans but would also include Aetna Medicare Rx plans and many others.
- Sort Results by - Premiums, Plan name, Plan rating, Popularity (Enrollment)
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Criteria that apply to a particular plan year must be entered in the appropriate column for the year (2007 or 2008) the search criteria include:
- Maximum Premium - Which plans under $20 in 2007 are still under $20 in 2008? - enter 20 in the 2007 column and 20 in the 2008 column (Answer: in Arizona, only 4 of the 6 plans under $20 in 2007 are still under $20 in 2008
- Maximum Deductible - is used just as maximum premium is above.
- Type of Gap Coverage - 2007 offered different levels of coverage in the Coverage Gap (Doughnut Hole) than 2008 select an option in the appropriate column 2007 or 2008.
- Full Low-Income Subsidy? - Choose one of the three options: Yes, show only plans that qualify, No, I receive no or only partial extra help, or Only show Plans that DO NOT qualify for $0 Premium. This option is used if you would like to see only plans which changed their qualification status. Example: select Yes... in the 2007 column and Only show Plans that DO NOT qualify ... in the 2008 column. You will see that in Arizona, 3 plans no longer qualify for the LIS $0 Premium status. Switch the 2007 and 2008 criteria to see that one plan qualifies in 2008 that did not qualify in 2007.
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:: Go to PDP-Compare
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Example 1: Changes in Current Plan
In this example our New York beneficiary wants to see what changes they can expect in their current plan. We have selected New York as our state. Note that State is the only field that must be entered prior to a search. Since the beneficiary is only interested in Humana Plans, we can narrow down the comparison by entering Humana or even Hum in the Partial Plan Name field. We have left the Full Low-Income Subsidy (LIS) field set to No... so that we will see plans which qualify and also those that do not qualify. Then click on Search
The comparison of the three Humana plans (Standard, Enhanced, and Complete) is shown and is shown for both 2007 and 2008. Our beneficiary can quickly see that the 2007 Humana Standard plan which qualified for the LIS $0 premium last year no longer qualifies in 2008. They can also see that the 2008 Enhanced plan is less expensive than its 2007 counterpart. Also, they can see that in 2007, 110,347 people enrolled in the Standard plan in New York and only 20,931 enrolled in the Enhanced plan. Note that the CMS Quality Ratings are the same for all three plans. The CMS Ratings are reported by company, not plan.
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:: Go to PDP-Compare to see this example: Humana Plans in New York
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Example 2: 2007 Plan no longer offered in 2008
This California beneficiary wants to see the changes in their Sierra Plus plan. They enter California in the State field (which is a required field) and since they only want to see Sierra plans, they enter Sierra in the Partial Plan Name field. They can leave the rest of the search fields empty and then click on Search.
The comparison of the three Sierra plans is shown for both 2007 and 2008. Our beneficiary can quickly see that the 2007 SierraRx plan and SierraRx Basic plan have not changed drastically for 2008. The SierraRx Plus plan from 2007 which had All Formulary Drugs covered, is no longer offered in 2008. Members of this plan will be automatically enrolled in a different Sierra plan unless they choose a new plan for themselves.
Our California beneficiary can see the CMS Quality Rating for the Sierra along with plan features and cost sharing information. Also, they can see that in 2007, 144,443 people across the country enrolled in the SierraRx plan in 2007 with 111,549 people California.
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:: Go to PDP-Compare to see this example: Sierra Plans in California
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Example 3: Change in Plan Coverage from 2007 to 2008
In this example our New York beneficiary wants to see what changes they can expect in their current plan. We have selected New York as our state. Note that State is the only field that must be entered prior to a search. Since the beneficiary is only interested in UnitedHealth Rx Plans, we can narrow down the comparison by entering United in the Partial Plan Name field. We have left all other criterien fields empty. Then click on Search
The comparison of the two UnitedHealth Rx plans is shown for both 2007 and 2008. Our beneficiary can see that the 2007 UnitedHealth Rx Extended plan is now the UnitedHealth Value plan in 2008. They can see that if the stay with their plan for 2008, they will now have a $275 deductible (in 2007 the Extended plan had a $0 deductible). and their premium will be reduced. The UnitedHealth Rx CMS Ratings are shown. Also shown is the Plan ID (a code that uniquely identifies the plan) and the 2007 enrollment figures for each plan.
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:: Go to PDP-Compare to see this example: UnitedHealth Rx Plans in New York
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Example 4: Advanced Search - Comparing Plans from Different Companies.
Our Arizona beneficiary wants to find a medium priced Medicare Part D plan and wishes to compare plans across different companies. Since there are 58 plans in Arizona, this comparison list could be a bit cumbersome. Our beneficiary does not want to spend more than $28 per month and does not want to pay a deductible.
This type of search is done by first selecting the State Arizona, and then entering our value 28 in the Maximum Premium field in the 2008 column and 0 in the Maximum Deductible field in the 2008 column. Since we and a medium priced plan and have entered our max, lets let the low priced plan fall to the bottom of the list by selecting 2008 Premium Highest to Lowest in the Sort Results by field. Then click on Search
Our comparison is reduced to only 9 plans rather than 58.
We can quickly compare the CMS Quality Rating, Premiums, Copays and Coinsurance, and even Plan Popularity across these plans. We can even see the individual plan changes from 2007 to 2008.
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:: Go to PDP-Compare for Arizona and enter 28 in the 2008 max premium and 0 in the 2008 max deductible -- sort by 2008 premium highest to lowest
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Example 5: Advanced Search - Premium increases in California
In this example our California beneficiary wants to see the changes in the most inexpensive Medicare Part D plans. We enter California in the State field, 10 in the 2007 Maximum Premium field, 265 in the 2007 Maximum Deductible field (or leave it blank since 265 is the 2007 maximum deductible. We entered 28 in the 2008 Maximum Premium field, 275 in the 2008Maximum Deductible field (or leave it blank since 275 is the 2008 maximum deductible. We changed the Sort Results by field to 2008 Premium Highest to Lowest.
Our comparison show two plans that meet our search criteria. The AARP plan increased $11.20 and no longer qualifies for the LIS $0 premium. The WellCare plan increased $9.30, still qualifies for the LIS $0 premium and for non-LIS recipients, the Deductible was decreased $15. The co-payments/co-insurance for both plans can quickly be compared to determine which plan best matches the prescription purchase patterns for the beneficiary.
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:: Go to PDP-Compare for California. For max premium enter 10 in 2007 28 in the 2008 -- sort by 2008 premium highest to lowest
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Chart Key: What do all of the Chart Fields Mean?
Below is a key or legend for the PDP-Compare Comparison Chart. The same key is shown just after the PDP-Compare Chart once you click on the Search button.
A few notes to help with the understanding of the 2008 Medicare Part D Plan chart above.
- Plan Name: This is the official plan name from CMS. The same plan name generally has a different plan id in each state.
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- CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.
This is a one to 5 star rating system with five (5) stars as excellent, four (4) stars as very good, three (3) stars as good, two (2) stars as fair and one (1) star as poor.
Cust. Service Rating - Drug Plan Customer Service - Medicare and members rate the drug plan and how well a drug plan provides customer service.
This category includes measures of how drug plans rate on the following areas:
- Time members and pharmacists are on hold when they call the drug plan’s customer call centers and pharmacy help desk.
- Calls disconnected by the drug plan’s customer call center and pharmacy help desk.
- Complaints Medicare has received about the drug plan.
- Members’ satisfaction related to getting help from the drug plan and their overall rating of the drug plan.
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Filling a Rx Rating - Using Your Plan To Get Your Prescriptions Filled - This category shows how well drug plans make prescription drugs available to their members.
This category includes measures of how drug plans rate on the following areas:
- Plan members’ ability to get prescriptions filled easily.
- Enrollment information the drug plan shares with pharmacists when a member needs a prescription filled.
- Information Medicare and the drug plan have about plan members who qualify for extra help.
- Complaints Medicare has received about the drug plan’s benefits and access to prescription drugs. These complaints include situations where your drug plan membership card doesn’t work at the pharmacy, or a pharmacy is listed incorrectly on Medicare’s website.
- Complaints Medicare has received about joining and leaving the drug plan. These complaints include situations where you don’t receive enrollment materials (like your membership card) from your drug plan, or you have difficulty switching to a new drug plan.
- How often a plan failed to make a timely appeals decision. Appeals are special kinds of requests you file when you disagree with certain decisions made by the drug plan about getting a prescription filled.
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RxCost Info Rating - This category shows how well drug plans are doing with pricing prescriptions and providing information on the Medicare website.
This category includes measures of how drug plans rate on the following areas:
- Availability of drug coverage and cost information from the drug plan and how often the plan’s drug prices change on the Medicare website.
- Complaints Medicare has received about pricing and out-of-pocket costs. These complaints include situations where you were charged the wrong price for a prescription, or the wrong plan premium amount was deducted from your Social Security check.
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- Monthly Premium: This is the amount you must pay each month to use the plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.
- Deductible: This is the $275 deductible that was presented in the CMS Standard Plan. Many provider's plans do not have a deductible, however the premium may be higher.
- Gap Coverage: the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3216.25 in drug costs (the Donut Hole). Many provider's plans cover the costs that fall into this category for an additional premium. In our chart, you will see one of the following:
- No Gap Coverage: you must pay the $3216.25;
- Some Generics, All Preferred Generics, All Generics : Various Generics are covered, but you must pay for Brand Drugs up to $3216.25;
- All Generic & Some Brands: One regional plan, only available in Florida covers all Generics and some of the Brands.
- $0 Premium with Full LIS - Does the plan Qualify for $0 Premium with Full Low-Income Subsidy?: If Yes is in the field, then you would pay a $0 premium if you have a Full Low-Income Subsidy (LIS). If No is in the field, then you would be responsible for the difference between what the state provides as the Full Low-Income Subsidy and the actual cost of the plan even if you have a Full Low-Income Subsidy.
- Plan ID: This is the unique id for this particular plan.
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- Copay / Coinsurance - Cost Sharing - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on which tier the drug is in. Plans can form their own tiers, so you should contact the plan or reference it's summary of benefits to find out what copays and limitations are associated with each tier. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap.
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- Plan Enrollment Figures - Currently we are showing the 2007 Medicare Part D plan enrollment figures (statistics) from July 2007. 2008 Enrollment Figures will be shown starting February 2008 and updated in July 2008. The enrollment statistics are split into three numbers
- In This State - This figure is the 2007 Medicare Part D plan enrollment statistic for this plan in this particular CMS region. In 25 of the 34 regions there is only one state, however some states are combined with others to form a region. Most notably, region 25 is made up of IA, MN, MT, NE, ND, SD, and WY. The enrollment that you see reported for any of these states is the combined enrollment for all of these states. The enrollment figures are reported by Medicare per Plan ID.
- Avg All States - This figure is the statistical average for this plan across all regions. This figure is approximate due to the fact that any region/plan enrollment under 10 enrollees is not reported.
- Total All States - This figure is the total count of enrollees in this plan across all regions. This figure is approximate due to the fact that any region/plan enrollment under 10 enrollees is not reported.
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(Chart Source: Centers for Medicare and Medicaid files: 2008LandscapeSourceData_PDP_09_25_07.xls, AnnualReportByPlan_Jul 2007_06262007.xls and Medicare.gov website plan finder.)
Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information. Through the application process we will provide you with the most up-to-the-minute information/pricing.
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Last updated on: 07/05/2009
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