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PDP-Facts: 2016 Medicare Part D Plan Statistics -
    Region (State) and National

Select a state to review the 2016 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 PR RI SC
SD TN TX UT VA VT WA WI WV WY

National Statistics:   2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008

2016 National Medicare Part D Plan Statistics*
and Averages per Region
Statistic 2016 Change 16-15 2015 Change 15-14 2014
Total Number of Part D Drug Plans 886 -115 1001 -168 1169
Average Nbr of Part D Plans per Region 26 -3 29 -5 34
Nbr of Enhanced (EA) Plans 448 -99 547 -37 584
Avg. Enhanced Plans per Region 13 -3 16 -1 17
Nbr of Basic (BA, DS, AE) Plans 438 -16 454 -131 585
Avg. Nbr of Basic Plans per Region 13 0 13 -4 17
Nbr of $0 Deductible Plans 290 -130 420 -133 553
Avg. Nbr of $0 Ded. Plans per Region 9 -3 12 -4 16
Percent $0 Deductible Plans 33% -9% 42% -5% 47%
Nbr of Plans with a Premium < $25 83 -22 105 -36 141
Avg Nbr of Plans - Premium < $25 2 -1 3 -1 4
Percent Plans with a Premium under $25 9% -1% 10% -2% 12%
Lowest Cost PDP Plan (Premium) $11.40 $-1.20 $12.60 $0.10 $12.50
Highest Cost PDP Plan (Premium) $174.70 $2.80 $171.90 $-2.80 $174.70
Average PDP Plan Premium (Cost) $53.83 $0.69 $53.14 $-0.66 $53.80
% Change in Avg. PDP Plan Costs -- 1% -- -1% --
Avg. Weighted PDP Plan Premium** $41.34 $4.66 $36.68 $-0.40 $37.08
% Change Weighted Avg. PDP Costs** -- 13% -- -1% --
Number of PDP Plans with Any Gap Coverage in the Gap (Donut Hole) 199 -62 261 -17 278
Percent of PDP Plans with Any Gap Coverage 22% -4% 26% 2% 24%
Lowest Cost Plan with Any Gap Coverage
View coverage type / premium details
$29.20 $-18.60 $47.80 $6.80 $41.00
Number of LIS PDP Plans
View List of LIS Qualified Plans
217 -66 283 -69 352
Nbr of Unique LIS Qualified Plans
View List of LIS Qualified Plans
16 -3 19 -7 26
Nbr of Plans with Premium Decrease 206 -261 467 66 401
Nbr of Plans with No Premium Change 43 16 27 3 24
Nbr of Plans with Premium Increase 601 139 462 -12 474
% of People with a Premium Increase 77.7% 11.7% 66% 3% 63%
Weighted Average Increase for People with a Premium Increase $7.40 $0.78 $6.62 $0.60 $6.02
Note: *Stand-alone Medicare Prescription Drug Plans (PDP)s only. Data for MA-PD plans not included. Sanctioned plans are included in this data. 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 for the Min. and Max. Premium Plans in 2016
H/LStatePlan NamePrem.Ded.Gap CoverageBenefit Type
LowARSilverScript Choice (PDP)$11.40$0.00No Gap CoverageBasic
HighFLBlueMedicare Rx-Option 2 (PDP)$174.70$0.00YesEnhanced
   
    The chart above shows the details of the least expensive and most
    expensive plans available for 2016.

Min. and Max. Premium Plans in 2015 and how the plan changes in 2016
H/LYearStatePlan NamePrem.Ded.Gap CoverageBenefit Type
Low2015NMSilverScript Choice (PDP)$12.60$0.00No Gap CoverageBasic
  2016NMSilverScript Choice (PDP)$12.00$0.00No Gap CoverageBasic
High2015FLBlueMedicare Rx-Option 2 (PDP)$171.90$0.00YesEnhanced
  2016FLBlueMedicare Rx-Option 2 (PDP)$174.70$0.00YesEnhanced
   
    The chart above details the least (and most) expensive plan in 2015 and
    plan features and costs should you stay in the same plan in 2016.

Gap Coverage Types and Minimum Premium for 2016 Part D Plans
2016 Gap Coverage Details
Gap Coverage TypeNumber
of Plans
Minimum
Premium
No Gap Coverage687$11.40
Yes199$29.20
2015 Gap Coverage Details
Gap Coverage TypeNumber
of Plans
Minimum
Premium
No Gap Coverage740$12.60
Yes261$47.80
    Notes: Click the Gap Coverage Type above to see plan details in California
               or choose your state.
Gap coverage applies to formulary drugs only. The Healthcare Reform provides that for Plan Year 2016, ALL formulary generics will have at least a 42% discount and ALL brand drugs will have at least a 55% discount in the coverage gap. The Gap Coverage discussed in this section is in addition to the Healthcare Reform mandated discounts.

$0 Premium LIS Qualified Part D Plans
2016 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Saver Plus (PDP)S5921
Aetna Medicare Rx Saver (PDP)S5810
Blue Cross MedicareRx Basic (PDP)S5715
Blue MedicareRx Value (PDP)S6506
Cigna-HealthSpring Rx Secure (PDP)S5617
EnvisionRxPlus Silver (PDP)S7694
Express Scripts Medicare - Value (PDP)S5660
Express Scripts Medicare - Value (PDP)S5983
Humana Preferred Rx Plan (PDP)S5552
Humana Preferred Rx Plan (PDP)S5884
Magellan Rx Medicare Basic (PDP)S4607
SilverScript Choice (PDP)S5601
Symphonix Value Rx (PDP)S0522
WellCare Classic (PDP)S5967
WellCare Simple (PDP)S4802
WellCare Simple (PDP)S2505
2015 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Saver Plus (PDP)S5921
Aetna Medicare Rx Saver (PDP)S5810
Blue Cross MedicareRx Basic (PDP)S5715
Blue MedicareRx Value (PDP)S6506
Cigna-HealthSpring Rx Secure (PDP)S5617
Colorado Access Vista Medicare PDP (PDP)S0962
EnvisionRxPlus Silver (PDP)S7694
Express Scripts Medicare - Value (PDP)S5983
Express Scripts Medicare - Value (PDP)S5660
Humana Preferred Rx Plan (PDP)S5884
Humana Preferred Rx Plan (PDP)S5552
SilverScript Choice (PDP)S5601
SmartD Rx Saver (PDP)S0064
Symphonix Rite Aid Value Rx (PDP)S0522
Transamerica MedicareRx Classic (PDP)S9579
United American - Select (PDP)S5755
WellCare Classic (PDP)S5967
WellCare Simple (PDP)S4802
WellCare Simple (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.



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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.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • 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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