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PDP-Facts: 2008 Medicare Part D Plan Facts -
    State and National

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National Statistics:
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2008 Texas Medicare Part D Plan Statistics
CMS Region 22 includes (TX)
Statistic 2009 Change 09-08 2008 Change 08-07 2007
Total Number of Part D Drug Plans
View list of National Providers
tbd tbd 56 -4 60
Nbr of Enhanced (EA) Plans tbd tbd 27 0 27
Nbr of Basic (BA, DS, AE) Plans tbd tbd 29 -4 33

Nbr of $0 Deductible Plans tbd tbd 33 -3 36
Percent $0 Deductible Plans tbd tbd 59% -1% 60%

Nbr of Plans with a Premium < $20 tbd tbd 4 -2 6
Percent Plans with a Premium < $20 tbd tbd 7% -3% 10%

Lowest Cost PDP Plan
View details of Lowest Cost Plan(s)
tbd tbd $12.10 $1.10 $11.00
Highest Cost PDP Plan
View details of Highest Cost Plan(s)
tbd tbd $97.50 $1.00 $96.50
Average Cost PDP Plan tbd tbd $38.10 $1.89 $36.21
% Change in Average PDP Plan Costs -- tbd -- 5% --

Number of PDP Plans with Any Gap Coverage in the Gap (Donut Hole) tbd tbd 16 -1 17
Percent of PDP Plans with Any Gap Coverage tbd tbd 29% 1% 28%
Lowest Cost Plan with Any Gap Coverage
View coverage type / premium details
tbd tbd $38.30 $4.70 $33.60

Total Beneficiaries with LIS tbd tbd 691,700 -- --
LIS Benchmark Premium $25.36 $0.35 $25.01 -- --
Number of LIS PDP Plans
View List of LIS Qualified Plans
tbd tbd 15 3 12

Premium Changes for Persons Staying in their Current Plan View premium detail chart
Nbr of Plans with Premium Increase tbd tbd 27 -- --
Nbr of Plans with No Premium Change tbd tbd 2 -- --
Nbr of Plans with Premium Decrease tbd tbd 22 -- --
Note: Stand-alone Medicare Prescription Drug Plans (PDP)s only.
Data for MA-PD plans not included.

» Details of the 2009 CMS Standard Plan including cost sharing, LIS benchmarks, etc.

2008 Premium Changes for
Texas Residents Staying in their 2007 Plan
Premium Change Range Total number of Plans in this Change Range
$-17 to $-13 * * -- total: 2 plans
$-12 to $-8 * -- total: 1 plan
$-7 to $-3 * * * -- total: 3 plans
$-2 to $2 * * * * * * * * * * * * * * * * * * -- total: 18 plans
$3 to $7 * * * * * * * * * * -- total: 10 plans
$8 to $12 * * * * * * * -- total: 7 plans
$13 to $17 * * * * -- total: 4 plans
$18 to $22 * * * -- total: 3 plans
$23 to $27 * -- total: 1 plan
$28 to $32 * -- total: 1 plan
$33 to $37 * -- total: 1 plan
               » Click to see change details on a per plan basis

Details for the Min. and Max. Premium Plans in 2008
H/LPlan NamePrem.Ded.Gap CoverageBenefit Type
LowHealth Net Orange Option 1$12.10$275.00No Gap CoverageBasic
HighEnvisionRxPlus Gold$97.50$0.00All Preferred GenericsEnhanced
               » Click to see 2009 Part D plan details
               The chart above shows the details of the least expensive and most expensive
               plans available in this state for 2008.

Min. and Max. Premium Plans in 2007 and their change in 2008
H/LYearPlan NamePrem.Ded.Gap CoverageBenefit Type
Low2007WellCare Classic$11.00$265.00No Gap CoverageBasic
Low2008WellCare Classic$24.60$250.00No Gap CoverageBasic

High2007SierraRx Plus$96.50$0.00All Formulary DrugsEnhanced
High2008--$0.00$0.00--

               » Click to see change details for all plans
               The chart above details the least ( and most) expensive plan in 2007 and
               plan features and costs should you stay in the same plan in 2008.

Gap Coverage Types and Minimum Premium for Texas Part D Plans
2008 Gap Coverage Details
Gap Coverage TypeNbr.
Plans
Min.
Prem.
No Gap Coverage40$12.10
All Preferred Generics7$38.30
All Generics8$38.40
Some Generics1$58.40
2007 Gap Coverage Details
Gap Coverage TypeNbr.
Plans
Min.
Prem.
None43$11.00
Generics16$33.60
All Formulary Drugs1$96.50
               Note: Click Gap Coverage Type above to see plan details.
Gap coverage descriptions apply to formulary drugs only. 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",
  • "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 Plans in Texas
2008 LIS Qualifying Plans
Plan NamePlan ID
BravoRxS1566-001
Prescription Pathway Bronze Plan Reg 22S5597-087
SilverScriptS5601-044
CIGNA Medicare Rx Plan OneS5617-108
Advantage Star Plan by RxAmericaS5644-079
Health Net Orange Option 2S5678-049
Health Net Orange Option 1S5678-050
Blue Medicare Rx - StandardS5715-009
First Health Part D-PremierS5768-045
Community CCRx BasicS5803-091
Aetna Medicare Rx EssentialsS5810-056
Scott & White Health Plan Texas Rx ValueS5915-003
HealthSpring Prescription Drug Plan-Reg 22S5932-021
MedicareRx Rewards StandardS5960-128
WellCare ClassicS5967-159
2007 LIS Qualifying Plans
Plan NamePlan ID
Bravo Rx IIS1566-001
Prescription Pathway Bronze Plan Reg 22S5597-087
CIGNATURE Rx Value PlanS5617-108
Advantage Star Plan by RxAmericaS5644-079
Health Net Orange Option 1S5678-050
First Health PremierS5768-045
Community Care Rx BASICS5803-091
Humana PDP Standard S5884-080S5884-080
AARP MedicareRx Plan - SaverS5921-191
HealthSpring Prescription Drug Plan-Reg 22S5932-021
WellCare SignatureS5967-056
WellCare ClassicS5967-159
               Note: Click heading above to see plan details

List of National PDP Providers
2008 National PDP Providers
Aetna Medicare
American Progressive Life & Health Ins Co of NY
Blue Medicare Rx
Blue MedicareRx
CIGNA Medicare Rx
Coventry AdvantraRx
EnvisionRx Plus
First Health Part D
First United American Life Insurance Company
Health Net
HealthSpring Prescription Drug Plan
Humana Insurance Company
Humana Insurance Company of New York
Medco Medicare Prescription Plan
MEMBERHEALTH
Pennsylvania Life Insurance Company
RxAmerica
SilverScript Insurance Company
Sterling Life Insurance Company
UniCare
United American Insurance Company
UnitedHealthcare
WellCare
2007 National PDP Providers
Aetna Medicare
American Progressive Life & Health Ins Co of NY
CIGNA HealthCare
Coventry AdvantraRx
EnvisionRx Plus
First Health Part D
Health Net
Humana Insurance Company
Humana Insurance Company of New York
Medco YOURx PLAN
MEMBERHEALTH
NMHC Group Solutions
Pennsylvania Life Insurance Company
RxAmerica
SAMAscript
SierraRx
SilverScript
Sterling Prescription Drug Plan
Unicare
United American Insurance Company
UnitedHealthcare
WellCare
               Note: Click heading above to see PDP plans and details


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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.