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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     : : Print Version
2012 National Medicare Part D Plan Statistics*
and Averages per Region
Statistic 2012 Change 12-11 2011 Change 11-10 2010
Total Number of Part D Drug Plans 1041 -68 1109 -467 1576
Average Nbr of Part D Plans per Region 31 -2 33 -13 46
Nbr of Enhanced (EA) Plans 500 -2 502 -293 795
Avg. Enhanced Plans per Region 15 0 15 -8 23
Nbr of Basic (BA, DS, AE) Plans 541 -66 607 -174 781
Avg. Nbr of Basic Plans per Region 16 -2 18 -5 23

Nbr of $0 Deductible Plans 488 24 464 -165 629
Avg. Nbr of $0 Ded. Plans per Region 14 0 14 -5 19
Percent $0 Deductible Plans 47% 5% 42% 2% 40%

Nbr of Plans with a Premium < $25 60 11 49 -42 91
Avg Nbr of Plans - Premium < $25 2 1 1 -2 3
Percent Plans with a Premium < $25 6% 2% 4% -2% 6%

Lowest Cost PDP Plan (Premium) $15.10 $0.30 $14.80 $6.00 $8.80
Highest Cost PDP Plan (Premium) $131.80 $-1.60 $133.40 $13.20 $120.20
Average PDP Plan Premium (Cost) $53.99 $-1.37 $55.36 $8.78 $46.58
% Change in Avg. PDP Plan Costs -- -2% -- 19% --
Avg. Weighted PDP Plan Premium** $39.62 $1.40 $38.22 $1.32 $36.90
% Change Weighted Avg. PDP Costs** -- 4% -- 4% --

Number of PDP Plans with Any Gap Coverage in the Gap (Donut Hole) 270 -129 399 91 308
Percent of PDP Plans with Any Gap Coverage 26% -10% 36% 16% 20%
Lowest Cost Plan with Any Gap Coverage
View coverage type / premium details
$54.50 $21.60 $32.90 $-7.50 $40.40

Number of LIS PDP Plans
View List of LIS Qualified Plans
327 12 315 27 288
Nbr of Unique LIS Qualified Plans
View List of LIS Qualified Plans
23 -1 24 -6 30

Premium Changes for Persons Staying in their Current Plan View premium detail chart
Nbr of Plans with Premium Decrease 369 132 237 -206 443
Nbr of Plans with No Premium Change 138 94 44 -14 58
Nbr of Plans with Premium Increase 420 -377 797 -313 1110
% of People with a Premium Increase 55% -10% 65% -16% 81%
Weighted Average Increase for People with a Premium Increase $4.99 $-2.31 $7.30 $1.82 $5.48
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 data is calculated per region. For example. A plan which is avalilable in CMS Region 6 which includes PA and WV is counted once, not twice.
**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.

Links above will take you to examples for California (or select your state once in PDP-Finder or PDP-Compare)

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

Details for the Min. and Max. Premium Plans in 2012
H/LStatePlan NamePrem.Ded.Gap CoverageBenefit Type
LowWIHumana Walmart-Preferred Rx Plan (PDP)$15.10$320.00No Gap CoverageBasic
HighDC DE MDBlueRx Enhanced (PDP)$131.80$0.00Many GenericsEnhanced
            : : Click to see 2012 Part D Plan details for California or choose your state.
            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
Low2011WIHumana Walmart-Preferred Rx Plan (PDP)$14.80$310.00No Gap CoverageBasic
Low2012WIHumana Walmart-Preferred Rx Plan (PDP)$15.10$320.00No Gap CoverageBasic

High2011DC DE MDBlueRx Enhanced (PDP)$133.40$0.00All GenericsEnhanced
High2012DC DE MDBlueRx Enhanced (PDP)$131.80$0.00Many GenericsEnhanced

            : : Click to see change details for all plans in California or choose your state.
            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 Coverage771$15.10
Some Generics102$54.50
Many Generics72$55.60
Few Generics16$61.00
All Generics7$66.60
Some Generics and Some Brands34$79.30
Many Generics and Some Brands39$101.20
2011 Gap Coverage Details
Gap Coverage TypeNbr.
Plans
Min.
Prem.
No Gap Coverage710$14.80
Few Generics102$32.90
Some Generics67$34.70
Many Generics117$39.90
All Generics7$72.80
Some Generics and Some Brands68$79.10
Many Generics and Some Brands38$91.20
               Notes: Click the Gap Coverage Type above to see plan details in California
               or choose your state.


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).


$0 Premium LIS Qualified 2012 Part D Plans
2012 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Preferred (PDP)S5805
AARP MedicareRx Preferred (PDP)S5820
Aetna CVS/pharmacy Prescription Drug Plan (PDP)S5810
Blue MedicareRx Standard (PDP)S5596
BravoRx (PDP)S5998
CIGNA Medicare Rx Plan One (PDP)S5617
Community CCRx Basic (PDP)S5825
Community CCRx Basic (PDP)S5803
CVS Caremark Value (PDP)S5601
EnvisionRxPlus Silver (PDP)S7694
First Health Part D Premier (PDP)S5768
First United American - Select (PDP)S5580
Health Net Orange Option 1 (PDP)S5678
HealthSpring Prescription Drug Plan -Reg12 (PDP)S5932
Humana Walmart-Preferred Rx Plan (PDP)S5884
Humana Walmart-Preferred Rx Plan (PDP)S5552
Medco Medicare Prescription Plan - Value (PDP)S5660
Medco Medicare Prescription Plan - Value (PDP)S5983
MedicareRx Rewards Standard (PDP)S5960
United American - Select (PDP)S5755
WellCare Classic (PDP)S5967
Windsor Rx (PDP)S2505
Windsor Rx (PDP)S4802
2011 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Preferred (PDP)S5820
AARP MedicareRx Preferred (PDP)S5805
Advantage Star Plan by RxAmerica (PDP)S5644
AR Blue Cross - Medi-Pak Rx Basic (PDP)S5795
Blue MedicareRx Standard (PDP)S5596
BravoRx (PDP)S5998
CIGNA Medicare Rx Plan One (PDP)S5617
Community CCRx Basic (PDP)S5803
Community CCRx Basic (PDP)S5825
CVS Caremark Value (PDP)S5601
EnvisionRxPlus Silver (PDP)S7694
First Health Part D Premier (PDP)S5768
Health Net Orange Option 1 (PDP)S5678
HealthSpring Prescription Drug Plan -Reg12 (PDP)S5932
Humana Walmart-Preferred Rx Plan (PDP)S5552
Humana Walmart-Preferred Rx Plan (PDP)S5884
Medco Medicare Prescription Plan - Value (PDP)S5660
Medco Medicare Prescription Plan - Value (PDP)S5983
MedicareBlue Rx Standard (PDP)S5743
MedicareRx Rewards Standard (PDP)S5960
Sterling Rx (PDP)S4802
UA Medicare Part D Prescription Drug Cov (PDP)S5755
WellCare Classic (PDP)S5967
Windsor Rx (PDP)S2505
               Note: Click heading above to see plan details in California or choose your state.
               Please note, not all plans are available in every state.


: : Charts & Figures     : : 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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