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PDP-Facts: 2012 Medicare Part D Plan Facts-
    Region (State) and National

Select a state to review the 2012 Medicare Prescription Drug Plan Statistics per State.
AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS
MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
National Statistics:   2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008

: : Charts & Figures   : : Summarized in Plain Text   : : Print Version
2012 New York Medicare Part D Plan Statistics*
CMS Region 3 includes (NY)
Statistic 2012 Change 12-11 2011 Change 11-10 2010
Total Number of Part D Drug Plans
View list of National Providers
29 -4 33 -17 50
Nbr of Enhanced (EA) Plans 13 -1 14 -10 24
Nbr of Basic (BA, DS, AE) Plans 16 -3 19 -7 26

Nbr of $0 Deductible Plans 13 1 12 -6 18
Lowest Premium for a $0 Ded. Plan $30.10 $-8.5 $38.60 $2.9 $35.70
Percent $0 Deductible Plans 45% 9% 36% 0% 36%

Nbr of Plans with a Premium < $25 1 0 1 0 1
Percent Plans with a Premium < $25 3% 0% 3% 1% 2%

Lowest Cost PDP Plan (Premium)
View details of Lowest Cost Plan(s)
$15.10 $0.30 $14.80 $-4.70 $19.50
Highest Cost PDP Plan (Premium)
View details of Highest Cost Plan(s)
$109.70 $1.90 $107.80 $-9.70 $117.50
Average PDP Plan Premium (Cost) $55.45 $0.39 $55.06 $7.11 $47.95
% Change in Avg. PDP Plan Costs -- 1% -- 15% --
Avg. Weighted PDP Plan Premium** $39.71 $2.71 $37.00 $3.31 $33.69
% Change Weighted Avg. PDP Costs** -- 7% -- 10% --

Number of PDP Plans with Any Gap Coverage in the Gap (Donut Hole) 7 -4 11 2 9
Percent of PDP Plans with Any Gap Coverage 24% -9% 33% 15% 18%
Lowest Cost Plan with Any Gap Coverage
View coverage type / premium details
$65.50 $20.00 $45.50 $-21.70 $67.20

Total Beneficiaries with LIS 763,653 763,653
LIS Benchmark Premium $39.79 $1.10 $38.69
Total Nbr of LIS Qualified Plans 12 1 11 1 10

Premium Changes for Persons Staying in their Current Plan View premium detail chart
Nbr of Plans with Premium Decrease 6 3 3 -8 11
Nbr of Plans with No Premium Change 3 1 2 1 1
Nbr of Plans with Premium Increase 17 -9 26 -11 37
% of People with a Premium Increase 88% -8% 96% 6% 90%
Weighted Average Increase for People with a Premium Increase $3.33 $-2.67 $6.00 $0.65 $5.35
Note: *Stand-alone Medicare Prescription Drug Plans (PDP)s only. Data for MA-PD plans not included. The data for the sanctioned Aetna plans is NOT included on this page.
**The plan premium weighted averages are calculated by multiplying the plan premium by the number of enrollees in the plan to give more "weight" to plans with more members.

: : Details of the 2012 CMS Standard Plan including cost sharing, LIS benchmarks, etc.

2012 Premium Changes for Persons Staying in their 2011 Plan
Premium Change Range Total number of Plans in this Change Range
$-32 to $-28 * -- total: 1 plan
$-27 to $-23 0 plans
$-22 to $-18 0 plans
$-17 to $-13 0 plans
$-12 to $-8 * -- total: 1 plan
$-7 to $-3 * -- total: 1 plan
$-2 to $2 * * * * * * -- total: 6 plans
$3 to $7 * * * * * * * * * * -- total: 10 plans
$8 to $12 * * * -- total: 3 plans
$13 to $17 * * -- total: 2 plans
$18 to $22 0 plans
$23 to $27 0 plans
$28 to $32 * -- total: 1 plan
            : : Click to see change details on a per plan basis

Details for the Min. and Max. Premium Plans in 2012
H/LStatePlan NamePrem.Ded.Gap CoverageBenefit Type
LowNYHumana Walmart-Preferred Rx Plan (PDP)$15.10$320.00No Gap CoverageBasic
HighNYSimply Prescriptions Rx 3 (PDP)$109.70$300.00Many GenericsEnhanced
            : : Click to see 2012 Part D Plan details for New York.
            The chart above shows the details of the least expensive and most expensive
            plans available for 2012.

Min. and Max. Premium Plans in 2011 and their change in 2012
H/LYearStatePlan NamePrem.Ded.Gap CoverageBenefit Type
Low2011NYHumana Walmart-Preferred Rx Plan (PDP)$14.80$310.00No Gap CoverageBasic
Low2012NYHumana Walmart-Preferred Rx Plan (PDP)$15.10$320.00No Gap CoverageBasic

High2011NYHumana Complete (PDP)$107.80$0.00Many Generics and Some BrandsEnhanced
High2012NYHumana Complete (PDP)$107.90$0.00Many Generics and Some BrandsEnhanced

            : : Click to see change details for all plans in New York.
            The chart above details the least (and most) expensive plan in 2011 and
            plan features and costs should you stay in the same plan in 2012.

Gap Coverage Types and Minimum Premium for 2012 Part D Plans
2012 Gap Coverage Details
Gap Coverage TypeNbr.
Plans
Min.
Prem.
No Gap Coverage22$15.10
Some Generics3$65.50
Many Generics2$95.20
Some Generics and Some Brands1$99.00
Many Generics and Some Brands1$107.90
2011 Gap Coverage Details
Gap Coverage TypeNbr.
Plans
Min.
Prem.
No Gap Coverage22$14.80
Few Generics3$45.50
Many Generics3$55.50
Some Generics2$64.60
Some Generics and Some Brands2$86.70
Many Generics and Some Brands1$107.80
               Notes: Click the Gap Coverage Type above to see plan details for 2012 New York plans.


Gap coverage descriptions apply to formulary drugs only. The Healthcare Reform provides that for Plan Year 2012, ALL formulary generics will have at least a 14% discount and ALL brand drugs will have at least a 50% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. The percentage of "Generic" and "Brand" drugs covered in the gap are each separately calculated and the following descriptions are used:
  • "All": 100% of formulary drugs of this type (generic or brand as noted) are covered through the gap. Ex: "All Generics". A label of "All Formulary Drugs" is applied for plans that cover 100% of "generic" and 100% of "brand" products (either by covering all formulary drug products in the gap or by having no initial coverage limit),
  • "Many": >=65% to <100% of formulary drugs of this type (generic or brand as noted) are covered through the gap. Ex: "Many Generics",
  • "Some": >=10% to <65 % of formulary drugs of this type (generic or brand as noted) are covered through the gap. Ex: "Some Generics",
  • "Few": >0% to <10% of formulary drugs of this type (generic or brand as noted) are covered through the gap (and must also be >15 products covered through the gap),
  • "No Gap Coverage": 0% of drugs are covered through the gap (or <=15 products covered through the gap).


2012 New York $0 Premium LIS Qualified Part D Plans
2012 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Preferred (PDP)S5805-001
Aetna CVS/pharmacy Prescription Drug Plan (PDP)S5810-037
BravoRx (PDP)S5998-001
CIGNA Medicare Rx Plan One (PDP)S5617-013
Community CCRx Basic (PDP)S5825-045
CVS Caremark Value (PDP)S5601-006
EnvisionRxPlus Silver (PDP)S7694-003
First United American - Select (PDP)S5580-006
HealthSpring Prescription Drug Plan -Reg 3 (PDP)S5932-004
Humana Walmart-Preferred Rx Plan (PDP)S5552-004
Medco Medicare Prescription Plan - Value (PDP)S5983-004
WellCare Classic (PDP)S5967-140
2011 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Preferred (PDP)S5805-001
Advantage Star Plan by RxAmerica (PDP)S5644-004
BravoRx (PDP)S5998-001
CIGNA Medicare Rx Plan One (PDP)S5617-013
Community CCRx Basic (PDP)S5825-045
CVS Caremark Value (PDP)S5601-006
EnvisionRxPlus Silver (PDP)S7694-003
HealthSpring Prescription Drug Plan -Reg 3 (PDP)S5932-004
Humana Walmart-Preferred Rx Plan (PDP)S5552-004
Medco Medicare Prescription Plan - Value (PDP)S5983-004
WellCare Classic (PDP)S5967-140
               Note: Click heading above to see details LIS qualifying plans in New York.
               Please note, not all plans are available in every state.

List of National PDP Providers with Plans available in New York
2012 National PDP Providers
Aetna Medicare
CIGNA Medicare Rx
Community CCRx PDP
EnvisionRx Plus
First Health Part D
HealthSpring Prescription Drug Plan
Humana Insurance Company of New York
Medco Medicare Prescription Plan
SilverScript Insurance Company
UniCare
UnitedHealthcare
2011 National PDP Providers
AETNA LIFE INSURANCE COMPANY
CIGNA Medicare Rx
EnvisionRx Plus
First Health Part D
First United American Life Insurance Company
HealthSpring Prescription Drug Plan
Humana Insurance Company of New York
Medco Medicare Prescription Plan
RxAmerica
SilverScript Insurance Company
UniCare
UnitedHealthcare
Universal American
               Note: Click heading above to see PDP plans and details for New York.


: : Charts & Figures   : : Summarized in Plain Text   : : Print Version

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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.


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