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2009 PDP-DrugFinder:
Helps you find the right Medicare Part D Plan!
Select a letter for the drug you wish to find. You will be take to a page show all Medicare Part D drugs beginning with this letter. Click on the medication. You will return to this page. Select your state (if not already shown). Then click "Search" to see all Medicare Part D plans which have this drug on their formulary and the plan premium, deductible, and drug cost-sharing details.
Just enter your preferences in the chart below and click Search.
You will instantly receive a list of the Medicare Part D plans that fulfill your requirements.
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What does all this mean? Here are a few notes to help you understand the above 2009 Medicare Part D Drug Finder (or PDP-DrugFinder).
- Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region).
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- Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.
- Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the the standard $295 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.
- Gap Coverage: (or the Donut Hole). Once a Medicare beneficiary exceeds the Initial Coverage Limit ($2700) in the CMS Standard Plan design, the beneficiary must pay the next $3453.75 in drug costs (the Donut Hole). Many Medicare Part D 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 100% of the next $3453.75 in prescription drug costs;
- Some Generics, All Preferred Generics, All Generics : Various Generics are covered, but you must pay 100% for Brand Name Drugs up to $3453.75;
- All Generic & Some Brands: One regional plan, only available in Florida covers all Generics and some of the Brands.
- Plan ID: This is the Medicare Part D prescription drug plan's unique ID.
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- Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
- Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have four (4) tiers 1=Preferred Generics, 2=Preferred Brands, 3=Non-preferred Brands and Generics, 4=Specialty Drugs.
- Drug Description - This is the Medicare Part D plan’s description of this particular drug tier.
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- Cost Sharing - Copay / Coinsurance - 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. The drug Tier is shown to the left of this column. 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. There are two figures shown under this "Cost Sharing" category:
- Network Preferred Pharmacy - (Ntwk. Pharm) - This is the cost-share amount you would pay during the intial coverage phase (until your total retail prescription drug costs reach $(2700)) at a network pharmacy.
- Mail Order - This is the cost-share amount you would pay during the initial coverage phase if you purchased your medication through your plan’s mail order partner(s).
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- Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
- None - This drug does not fall under any drug utilization management controls.
- P - Prior Authorization -This drug is subject to prior authorization.
- S - Step Therapy -This drug is subject to step therapy.
- Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.
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(Chart Source: Centers for Medicare and Medicaid files: CMS Data (06/31/2009) )
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, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.
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Last updated on: 09/22/2011
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