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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 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.
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2016 Premium Changes for Persons Staying in their 2015 Plan |
Premium Change Range | Total number of Plans in this Change Range |
$-58 to $-54 | * -- total: 1 plan |
$-53 to $-49 | 0 plans |
$-48 to $-44 | 0 plans |
$-43 to $-39 | 0 plans |
$-38 to $-34 | 0 plans |
$-33 to $-29 | 0 plans |
$-28 to $-24 | 0 plans |
$-23 to $-19 | * -- total: 1 plan |
$-18 to $-14 | * -- total: 1 plan |
$-13 to $-9 | 0 plans |
$-8 to $-4 | 0 plans |
$-3 to $1 | * * * * * * * -- total: 7 plans |
$2 to $6 | * * * * -- total: 4 plans |
$7 to $11 | * * * -- total: 3 plans |
$12 to $16 | * * * * -- total: 4 plans |
$17 to $21 | * -- total: 1 plan |
$22 to $26 | * -- total: 1 plan |
$27 to $31 | * -- total: 1 plan |
$32 to $36 | 0 plans |
$37 to $41 | 0 plans |
$42 to $46 | 0 plans |
$47 to $51 | 0 plans |
$52 to $56 | 0 plans |
$57 to $61 | 0 plans |
$62 to $66 | 0 plans |
$67 to $71 | 0 plans |
$72 to $76 | 0 plans |
$77 to $81 | 0 plans |
$82 to $86 | * -- total: 1 plan | |
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Details for the Min. and Max. Premium Plans in 2016 |
H/L | State | Plan Name | Prem. | Ded. | Gap Coverage | Benefit Type |
Low | NC | Humana Walmart Rx Plan (PDP) | $18.40 | $360.00 | No Gap Coverage | Enhanced |
High | NC | Transamerica MedicareRx Classic (PDP) | $120.50 | $360.00 | No Gap Coverage | Basic | |
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The chart above shows the details of the least expensive and most |
expensive plans available for 2016.
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Min. and Max. Premium Plans in 2015 and how the plan changes in 2016 |
H/L | Year | State | Plan Name | Prem. | Ded. | Gap Coverage | Benefit Type |
Low | 2015 | NC | Humana Walmart Rx Plan (PDP) | $15.70 | $320.00 | No Gap Coverage | Enhanced |
| 2016 | NC | Humana Walmart Rx Plan (PDP) | $18.40 | $360.00 | No Gap Coverage | Enhanced |
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High | 2015 | NC | Aetna Medicare Rx Premier (PDP) | $133.50 | $0.00 | Yes | Enhanced |
| 2016 | NC | Members will be assigned to First Health Part D Premier Plus (PDP) S5768-167 | $0.00 | $0.00 | -- | -- | |
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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.
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Gap Coverage Types and Minimum Premium for 2016 Part D Plans |
2016 Gap Coverage Details |
Gap Coverage Type | Number of Plans | Minimum Premium |
No Gap Coverage | 20 | $18.40 |
Yes | 6 | $33.50 |
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2015 Gap Coverage Details |
Gap Coverage Type | Number of Plans | Minimum Premium |
No Gap Coverage | 21 | $15.70 |
Yes | 8 | $50.60 |
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Notes: Click the Gap Coverage Type above to see plan details for 2016 North Carolina plans. |
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.
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2016 North Carolina $0 Premium LIS Qualified Part D Plans |
2016 LIS Qualifying Plans |
Plan Name | Plan ID |
Aetna Medicare Rx Saver (PDP) | S5810-042 |
Humana Preferred Rx Plan (PDP) | S5884-133 |
SilverScript Choice (PDP) | S5601-016 |
Symphonix Value Rx (PDP) | S0522-010 |
WellCare Classic (PDP) | S5967-145 |
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2015 LIS Qualifying Plans |
Plan Name | Plan ID |
AARP MedicareRx Saver Plus (PDP) | S5921-353 |
Aetna Medicare Rx Saver (PDP) | S5810-042 |
Cigna-HealthSpring Rx Secure (PDP) | S5617-217 |
Humana Preferred Rx Plan (PDP) | S5884-133 |
SilverScript Choice (PDP) | S5601-016 |
SmartD Rx Saver (PDP) | S0064-008 |
Symphonix Rite Aid Value Rx (PDP) | S0522-010 |
WellCare Classic (PDP) | S5967-145 |
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Note: Click heading above to see details of LIS qualifying plans in North Carolina.
Please note, not all plans are available in every state.
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List of National PDP Providers with Plans available in North Carolina |
2016 National PDP Providers |
Aetna Medicare |
Cigna-HealthSpring Rx |
EnvisionRx Plus |
Express Scripts Medicare |
First Health Part D |
Humana Insurance Company |
SilverScript |
United American Insurance Company |
UnitedHealthcare |
WellCare |
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2015 National PDP Providers |
Aetna Medicare |
Cigna-HealthSpring Rx |
Express Scripts Medicare |
First Health Part D |
Humana Insurance Company |
United American Insurance Company |
UnitedHealthcare |
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Note: Click heading above to see PDP plans and details for North Carolina.
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