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Find a 2013 Stand-Alone Medicare Part D Prescription Drug Plan

PDP-Finder shows basic details for all 2013 Medicare Part D Plans.

Not sure where to begin? Just "click" on your state to see all 2013 Medicare Part D plans:
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MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY

Choose Your Medicare Part D Prescription Drug Plan Preferences
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Maximum Premium:$max: $166
Maximum Deductible:$max: $325
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 with a $0 Tier 1 Co-pay
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Additional Info:
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: : Link to This Chart.
There are 32 Stand-Alone 2013 Medicare Part D plans that meet your criteria.
Click below to access enrollment options (including download, online, and telephone).
2013 Medicare Part D Plan Information
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Plan Name Monthly
Prem.
Deduct-
ible
(Donut Hole)
Gap
Coverage
$0 Prem.
with Full
LIS?
Plan
ID
Preferred Pharmacy
Copay/
Coinsurance
30-Day Supply
Total Formulary Drugs
Cust.
Service
Rating
Member
Plan
Exper.
RxCost
Info
Rating
AARP MedicareRx Saver Plus (PDP)


      
$15.00 $325 No Gap Coverage Yes S5921
-376
Preferred Generic: $1.00
Non-Preferred Generic: $2.00
Preferred Brand: $25.00
Non-Preferred Brand: $45.00
Specialty Tier: 25%
3282

Browse Formulary
AARP MedicareRx Saver Plus (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) AARP MedicareRx Saver Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) AARP MedicareRx Saver Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Humana Walmart-Preferred Rx Plan (PDP)


      
$18.50 $325 No Gap Coverage Yes S5884
-114
Preferred Generics: $1.00
Non-Preferred Generics: $3.00
Preferred Brand: 20%
Non-Preferred Brand: 35%
Specialty: 25%
3251

Browse Formulary
Humana Walmart-Preferred Rx Plan (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Humana Walmart-Preferred Rx Plan (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) Humana Walmart-Preferred Rx Plan (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
First Health Part D Value Plus (PDP)


      
$24.40 $0 No Gap Coverage No S5768
-155
Preferred Generic Drugs: $0.00
Preferred Brand Drugs: $35.00
Non-Preferred Brand Drugs: $70.00
Specialty Tier Drugs: 33%
3118

Browse Formulary
First Health Part D Value Plus (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) First Health Part D Value Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) First Health Part D Value Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Aetna CVS/pharmacy Prescription Drug Plan (PDP)


      
$28.60 $325 No Gap Coverage Yes S5810
-066
Preferred generic: $2.00
Non-preferred generic: $5.00
Preferred brand: $45.00
Non-preferred brand: 47%
Specialty: 25%
3300

Browse Formulary
Aetna CVS/pharmacy Prescription Drug Plan (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Aetna CVS/pharmacy Prescription Drug Plan (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) Aetna CVS/pharmacy Prescription Drug Plan (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
EnvisionRxPlus Silver (PDP)


      
$29.10 $325 No Gap Coverage Yes S7694
-032
Preferred Generic: 25%
Non-Preferred Generic: 25%
Preferred Brand: 23%
Non-Preferred Brand: 28%
Specialty Tier: 25%
2711

Browse Formulary
EnvisionRxPlus Silver (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) EnvisionRxPlus Silver (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Fair) EnvisionRxPlus Silver (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Plan Name Monthly
Prem.
Deduct-
ible
Gap
Coverage
$0 Prem
LIS?
Plan
ID
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. CostInfo
SilverScript Choice (PDP)


      
$29.10 $0 No Gap Coverage No S5601
-141
Generics: $0.00
Preferred Brands: $34.00
Non-Preferred Brand Drugs: 35%
Specialty: 33%
2875

Browse Formulary
SilverScript Choice (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) SilverScript Choice (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) SilverScript Choice (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
SilverScript Basic (PDP)


      
$30.60 $325 No Gap Coverage Yes S5601
-064
Generics: $2.00
Preferred Brands: 21%
Non-Preferred Brand Drugs: 43%
Specialty: 33%
2875

Browse Formulary
SilverScript Basic (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) SilverScript Basic (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) SilverScript Basic (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
SmartD Rx Saver (PDP)


      
$31.40 $325 No Gap Coverage Yes S0064
-032
Preferred Generics: $0.00
Non-preferred Generics: $20.00
Preferred Brands: $32.00
Non-preferred Brands: $85.00
Specialty: 25%
3178

Browse Formulary
new new new
Reader's Digest Value Rx (PDP)


      
$32.30 $325 No Gap Coverage No S0128
-033
Preferred Generic: $1.00
Non-preferred Generic: $2.50
Preferred Brand: $37.00
Non-preferred Brand: 27%
3112

Browse Formulary
new new new
WellCare Classic (PDP)


      
$33.00 $0 No Gap Coverage No S5967
-169
Preferred Generic: $6.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%
2835

Browse Formulary
WellCare Classic (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) WellCare Classic (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) WellCare Classic (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
United American - Select (PDP)


      
$36.50 $325 No Gap Coverage No S5755
-103
Preferred Generic Drugs: $1.00
Non-Preferred Generic Drugs: $4.00
Preferred Brand Name Drugs: $37.00
Non-Preferred Brand Name Drugs: $95.00
Specialty Drugs: 25%
3131

Browse Formulary
United American - Select (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) United American - Select (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) United American - Select (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Plan Name Monthly
Prem.
Deduct-
ible
Gap
Coverage
$0 Prem
LIS?
Plan
ID
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. CostInfo
Blue Cross MedicareRx Standard (PDP)


      
$41.30 $325 No Gap Coverage No S5596
-033
Preferred Generic: $2.00
Non-Preferred Generic: $6.00
Preferred Brand: $39.00
Non-Preferred Brand: $85.00
Injectable Drugs: 25%
Specialty Tier: 25%
2838

Browse Formulary
Blue Cross MedicareRx Standard (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) Blue Cross MedicareRx Standard (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Fair) Blue Cross MedicareRx Standard (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
HealthSpring Prescription Drug Plan-Reg 32 (PDP)


      
$46.90 $325 No Gap Coverage No S5932
-031
Forumlary Drugs: 25%
3027

Browse Formulary
HealthSpring Prescription Drug Plan-Reg 32 (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) HealthSpring Prescription Drug Plan-Reg 32 (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) HealthSpring Prescription Drug Plan-Reg 32 (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Fair)
Humana Enhanced (PDP)


      
$47.40 $0 No Gap Coverage No S5884
-030
Preferred Generic: $2.00
Non-Preferred Generic: $5.00
Preferred Brand: $44.00
Non-Preferred Brand: $90.00
Specialty: 33%
3923

Browse Formulary
Humana Enhanced (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Humana Enhanced (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) Humana Enhanced (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
AARP MedicareRx Preferred (PDP)


      
$47.90 $0 No Gap Coverage No S5820
-031
Preferred Generics: $3.00
Non-Preferred Generic: $5.00
Preferred Brand: $40.00
Non-Preferred Brand: $85.00
Specialty Tier: 33%
3829

Browse Formulary
AARP MedicareRx Preferred (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) AARP MedicareRx Preferred (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) AARP MedicareRx Preferred (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
First Health Part D Premier (PDP)


      
$47.90 $325 No Gap Coverage No S5768
-082
Preferred Generic Drugs: $3.00
Preferred Brand Drugs: 25%
Non-Preferred Brand Drugs: 48%
3113

Browse Formulary
First Health Part D Premier (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) First Health Part D Premier (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) First Health Part D Premier (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
WellCare Extra (PDP)


      
$49.00 $0 Many Generics No S5967
-203
Preferred Generic: $0.00
Non-Preferred Generic: 25%
Preferred Brand: 25%
Non-Preferred Brand: 50%
Specialty Tier: 33%
2835

Browse Formulary
WellCare Extra (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) WellCare Extra (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) WellCare Extra (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Plan Name Monthly
Prem.
Deduct-
ible
Gap
Coverage
$0 Prem
LIS?
Plan
ID
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. CostInfo
Blue Shield Medicare Basic Plan (PDP)


      
$53.40 $325 No Gap Coverage No S2468
-003
Preferred Generic: $4.00
Preferred Brand: $37.00
Non-Preferred Brand: $76.00
Injectable Drugs: 25%
Specialty Tier: 25%
3041

Browse Formulary
Blue Shield Medicare Basic Plan (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) Blue Shield Medicare Basic Plan (PDP) Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Blue Shield Medicare Basic Plan (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Very Good)
EnvisionRxPlus Gold (PDP)


      
$54.00 $150 Some Generics No S7694
-102
Preferred Generic: $2.00
Non-Preferred Generic: $5.00
Preferred Brand: $25.00
Non-Preferred Brand: 30%
Specialty Tier: 29%
2747

Browse Formulary
EnvisionRxPlus Gold (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) EnvisionRxPlus Gold (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Fair) EnvisionRxPlus Gold (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Cigna Medicare Rx Plan One (PDP)


      
$55.80 $325 No Gap Coverage No S5617
-158
Preferred Generic Drugs: $0.00
Non-Preferred Generic Drugs: $8.00
Preferred Brand Drugs: $28.00
Non-Preferred Brand Drugs: $70.00
Specialty Tier: 25%
3494

Browse Formulary
Cigna Medicare Rx Plan One (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Cigna Medicare Rx Plan One (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) Cigna Medicare Rx Plan One (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Fair)
United American - Enhanced (PDP)


      
$60.80 $80 No Gap Coverage No S5755
-035
Preferred Generic: $1.00
Non-Preferred Generic: $1.00
Preferred Brand: $40.00
Non-Preferred Brand: $95.00
Specialty: 29%
3381

Browse Formulary
United American - Enhanced (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) United American - Enhanced (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) United American - Enhanced (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Express Scripts Medicare - Value (PDP)


      
$61.00 $325 No Gap Coverage No S5660
-134
Preferred Generic Drugs: $4.00
Non-Preferred Generic Drugs: $7.00
Preferred Brand Drugs: 25%
Non-Preferred Brand Drugs: 50%
Specialty Tier Drugs: 25%
3381

Browse Formulary
Express Scripts Medicare - Value (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Express Scripts Medicare - Value (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) Express Scripts Medicare - Value (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Very Good)
Blue Shield Medicare Enhanced Plan (PDP)


      
$72.50 $0 No Gap Coverage No S2468
-004
Preferred Generic: $5.00
Preferred Brand: $45.00
Non-Preferred Brand: $90.00
Injectable Drugs: 25%
Specialty Tier: 33%
3331

Browse Formulary
Blue Shield Medicare Enhanced Plan (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) Blue Shield Medicare Enhanced Plan (PDP) Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Blue Shield Medicare Enhanced Plan (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Very Good)
Plan Name Monthly
Prem.
Deduct-
ible
Gap
Coverage
$0 Prem
LIS?
Plan
ID
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. CostInfo
SmartD Rx Plus (PDP)


      
$73.00 $0 Some Generics No S0064
-067
Preferred Generics: $0.00
Non-preferred Generics: $20.00
Preferred Brands: $32.00
Non-preferred Brands: $85.00
Specialty: 25%
3178

Browse Formulary
new new new
Blue Cross MedicareRx Plus (PDP)


      
$76.80 $0 Few Generics No S5596
-034
Preferred Generic: $2.00
Non-Preferred Generic: $7.00
Preferred Brand: $45.00
Non-Preferred Brand: $90.00
Injectable Drugs: $95.00
Specialty Tier: 33%
3107

Browse Formulary
Blue Cross MedicareRx Plus (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) Blue Cross MedicareRx Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Fair) Blue Cross MedicareRx Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Express Scripts Medicare - Choice (PDP)


      
$91.60 $200 Many Generics No S5660
-202
Generic Drugs: $8.00
Preferred Brand Drugs: $45.00
Non-Preferred Brand Drugs: $95.00
Specialty Tier Drugs: 28%
3408

Browse Formulary
Express Scripts Medicare - Choice (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Express Scripts Medicare - Choice (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) Express Scripts Medicare - Choice (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Very Good)
AARP MedicareRx Enhanced (PDP)


      
$98.00 $0 Some Generics and
Some Brands
No S5921
-003
Preferred Generic: $2.00
Non-Preferred Generic: $5.00
Preferred Brand: $40.00
Non-Preferred Brand: $76.00
Specialty Tier: 33%
4971

Browse Formulary
AARP MedicareRx Enhanced (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) AARP MedicareRx Enhanced (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) AARP MedicareRx Enhanced (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
First Health Part D Premier Plus (PDP)


      
$102.40 $0 Some Generics and
Some Brands
No S5674
-059
Preferred Generic Drugs: $0.00
Non-Preferred Generic Drugs: $20.00
Preferred Brand Drugs: 25%
Non-Preferred Brand Drugs: 43%
Specialty Drugs: 33%
3173

Browse Formulary
First Health Part D Premier Plus (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) First Health Part D Premier Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) First Health Part D Premier Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Very Good)
Blue Cross MedicareRx Gold (PDP)


      
$113.00 $0 Many Generics and
Some Brands
No S5596
-035
Preferred Generic: $2.00
Non-Preferred Generic: $7.00
Preferred Brand: $45.00
Non-Preferred Brand: $90.00
Injectable Drugs: $95.00
Specialty Tier: 33%
4173

Browse Formulary
Blue Cross MedicareRx Gold (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) Blue Cross MedicareRx Gold (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Fair) Blue Cross MedicareRx Gold (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Plan Name Monthly
Prem.
Deduct-
ible
Gap
Coverage
$0 Prem
LIS?
Plan
ID
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. CostInfo
SilverScript Plus (PDP)


      
$113.10 $0 Many Generics and
Some Brands
No S5601
-065
Generics: $0.00
Preferred Brands: $34.00
Non-Preferred Brand Drugs: 35%
Specialty: 33%
2875

Browse Formulary
SilverScript Plus (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Good) SilverScript Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) SilverScript Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Aetna Medicare Rx Premier (PDP)


      
$118.40 $0 Many Generics and
Some Brands
No S5810
-202
Preferred generic: $5.00
Non-preferred generic: $33.00
Preferred brand: $45.00
Non-preferred brand: 0%
Specialty: 25%
3364

Browse Formulary
Aetna Medicare Rx Premier (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Aetna Medicare Rx Premier (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Very Good) Aetna Medicare Rx Premier (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)
Humana Complete (PDP)


      
$118.60 $0 Some Generics and
Some Brands
No S5884
-060
Preferred Generic: $5.00
Preferred Brand: $37.00
Non-Preferred Brand: $69.00
Specialty: 33%
3937

Browse Formulary
Humana Complete (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Very Good) Humana Complete (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Good) Humana Complete (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Good)



A few notes to help with the understanding of the 2013 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.
  • Plan Name: This is the official plan name from the Centers for Medicare and Medicaid Services (CMS). The same plan name generally has a different plan id in each state. (Search Tip: If you would like to reduce the plans shown to just plans for one or two specific carriers, you can select the carrier name in the "Plan Family" fields 1 and 2. Select the empty (blank) option at the top of the list to remove the criteria. You can also click the "National Plans" checkbox to limit your search to just national plans.)

  • CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.

    This is a 1 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 on Hold When Customer and Pharmacist Calls Drug Plan.
    • Calls Disconnected When Customer and Pharmacist Calls Drug Plan.
    • Drug Plan’s Timeliness in Giving a Decision for Members Who Make an Appeal.
    • Fairness of Drug Plan’s Denials to a Member’s Appeal, Based on an Independent Reviewer.

  • Member Plan Exper. - Member Experience with Drug Plan - 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:
    • Drug Plan Provides Information or Help When Members Need It.
    • Members’ Overall Rating of Drug Plan.
    • Members’ Ability to Get Prescriptions Filled Easily When Using the Drug Plan.

  • 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:
    • Completeness of the Drug Plan’s Information on Members Who Need Extra Help.
    • Drug Plan Provides Current Information on Costs and Coverage for Medicare’s Website (the same data is used on this Q1Medicare.com).
    • Drug Plan’s Prices that Did Not Increase More Than Expected During the Year.
    • Drug Plan’s Prices on Medicare’s Website (and this website) Are Similar to the Prices Members Pay at the Pharmacy.
    • Drug Plan’s Members 65 and Older Who Received Prescriptions for Certain Drugs with a High Risk of Side Effects, when There May Be Safer Drug Choices.

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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. (Search Tip: If you would like to reduce the plans shown to just plans under a certain premium, enter this value in the "Maximum Premium" field.)

  • Deductible: This is the $325 deductible that was presented in the CMS Standard Plan. Many provider’s plans do not have a deductible, however the premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible field" field.)

  • Gap Coverage: the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3763.75 in drug costs (the Donut Hole). The Healthcare Reform provides that for Plan Year 2013, ALL formulary generics will have at least a 21% discount and ALL brand drugs will have at least a 52.5% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
    • No Gap Coverage: you must pay the $3763.75;

    • Few Generics: less than 10% of formulary generics are covered, but you must pay for Brand Drugs up to $3763.75;

    • Some Generics: 10% to 65% of formulary generics are covered, but you must pay for Brand Drugs up to $3763.75;

    • Many Generics: 65% to 100% of formulary generics are covered, but you must pay for Brand Drugs up to $3763.75;

    • All Generics : All formulary Generics are covered, but you must pay for Brand Drugs up to $3763.75;

    • Many Generics & Some Brands: These Medicare prescription drug plans cover 65% to 100% of formulary generics and a some (10% to 65%) of Brand drugs on the plan’s formulary.

    • Some Generics & Some Brands: These Medicare prescription drug plans cover 10% to 65% of Generic and Brand drugs on the plan’s formulary. (Search Tip: If you would like to reduce the plans shown to just plans with a certain type of gap coverage, select this type of coverage in the "Type of Gap Coverage" field.)

  • $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. (Search Tip: If you would like to reduce the plans shown to just plans that qualify for the $0 premium (Benchmark plans), select "Yes..." in the "Full Low-Income Subsidy?" field.)

  • 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. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the "Max. Co-pay Tier 1 (Generics)" field.)

Additional Information Fields:
You can select one of the following additional pieces of plan information to display (Search Tip: to change the type of information shown in the last column of the chart, select the data to be shown in the "Additional Info" field.)
  • Total Formulary Drugs (default) - This is the total number of medications on the plans formulary or drug list. For 2013 Medicare Part D plans, the smallest formulary is the EnvisionRxPlus Silver (PDP) formulary with 2,380 total medications and the largest formulary is the AmeriHealth Rx Option II formulary (PA & WV) with 4,985 total formulary drugs. This total drug count does not include "Bonus Drugs". These are non-Medicare Part D drugs which are covered by the plan, however they do not count toward your plan deductible, retail drug cost, or TrOOP.
  • Offers Mail Order - "Yes" is displayed if this plan offers mail order on any medications. It does NOT mean that ALL medications are available through mail order.
  • Members in This State (updated: August 2013 figures) - This is the total number of members in this plan for this CMS Region. For regions which contain more than one state, this is the total for all of those states combined. We are showing the latest Medicare Part D plan enrollment figures. We update this figure as new enrollment statistics are released by Medicare.
  • Members Nation Wide (updated: August 2013 figures) - This is the total number of member for this plan in all CMS Regions (States) combined. We are showing the latest Medicare Part D plan enrollment figures. We update this figure as new enrollment statistics are released by Medicare.

  • Initial Coverage Limit (ICL) - The initial coverage limit phase of a Medicare Part D plan is the phase AFTER the initial deductible is met (if the plan has an initial deductible) and BEFORE the coverage gap (or donut hole) begins. The ICL is the phase of the prescription drug plan during which you and your plan share your prescription costs. During this phase you will pay either a co-payment (a flat fee per prescription) or co-insurance (a percentage of the drug cost). The details of the cost-sharing for the plan are shown in the Cost-Sharing column directly to the left of this column. The CMS standard Initial Coverage Limit for 2013 is $2970 and increases each year.
  • National or Regional Plans - This column simply displays the word "National" if the plan is sponsored by a national carrier or "Regional" if the plan sponsor is a regional carrier.


(Chart Source: various files provided by the Centers for Medicare and Medicaid Services along with data from the 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.



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