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2012
2013
2012: $  max: $132
2013: $  max: $166
2012: $  max: $320
2013: $  max: $325
2012:
2013:
2012:
2013:
There are 44 Pennsylvania Stand-Alone Medicare Part D plans meeting your criteria.
2012 / 2013 Medicare Part D Plan Information
Click here to jump to the Chart Legend
Plan Name Monthly
Premium
Deduct-
ible
(Donut Hole)
Additional
Gap
Coverage
$0
Prem.
with
Full
LIS?
Plan
ID
Cost-Sharing Members In This Plan
Cust.
Service
Rating
Member
Plan
Exper.
RxCost
Info
Rating
Tier
1
Tier
2
Tier
3
Tier
4

-- This plan not offered in 2012 --

S5921
-351
     
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 AARP MedicareRx Saver Plus (PDP)
$15.00 $325 No additional gap coverage, only the Donut Hole Discount Yes$1.00$2.00$25.00$45.00tbd members
2012 Humana Walmart-Preferred Rx Plan (PDP)
$15.10 $320 No additional gap coverage, only the Donut Hole Discount Yes S5884
-104
$1.00$5.0020%35%
56,208 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Humana Walmart-Preferred Rx Plan (PDP)
$18.50 $325 No additional gap coverage, only the Donut Hole Discount Yes$1.00$5.0020%35%tbd members
2012 First Health Part D Value Plus (PDP)
$23.90 $0 No additional gap coverage, only the Donut Hole Discount No S5768
-129
$0.0025%40%33%
20,743 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 First Health Part D Value Plus (PDP)
$28.20 $0 No additional gap coverage, only the Donut Hole Discount No$0.00$35.00$70.0033%tbd members

-- This plan not offered in 2012 --

S5601
-115
     
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 SilverScript Choice (PDP)
$29.10 $0 No additional gap coverage, only the Donut Hole Discount No$0.00$34.0035%33%tbd members
2012 Aetna CVS/pharmacy Prescription Drug Plan (PDP)
$26.00 $320 No additional gap coverage, only the Donut Hole Discount Yes S5810
-040
$3.00$21.00$35.0040%
7,448 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 Aetna CVS/pharmacy Prescription Drug Plan (PDP)
$32.50 $325 No additional gap coverage, only the Donut Hole Discount Yes$2.00$5.00$45.0046%tbd members
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 CVS Caremark Value (PDP)
$30.20 $320 No additional gap coverage, only the Donut Hole Discount Yes S5601
-012
$5.00$45.00$95.0025%
65,473 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 SilverScript Basic (PDP)
$34.00 $325 No additional gap coverage, only the Donut Hole Discount Yes$2.0023%45%33%tbd members

-- This plan not offered in 2012 --

S0064
-006
     
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2013 SmartD Rx Saver (PDP)
$35.10 $325 No additional gap coverage, only the Donut Hole Discount Yes$0.00$20.00$31.00$85.00tbd members
2012 EnvisionRxPlus Silver (PDP)
$33.10 $320 No additional gap coverage, only the Donut Hole Discount Yes S7694
-006
25%25%25%25%
18,775 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 EnvisionRxPlus Silver (PDP)
$35.20 $325 No additional gap coverage, only the Donut Hole Discount Yes25%25%23%28%tbd members

-- This plan not offered in 2012 --

S9014
-003
     
new new new  
2013 SecureAdvantage Rx - Option 1 (PDP)
$35.60 $325 No additional gap coverage, only the Donut Hole Discount Yes25%25%25%25%tbd members

-- This plan not offered in 2012 --

S0128
-007
     
new new new  
2013 Reader's Digest Value Rx (PDP)
$35.80 $325 No additional gap coverage, only the Donut Hole Discount Yes$1.00$2.50$35.0027%tbd members
2012 CIGNA Medicare Rx Plan One (PDP)
$31.70 $320 No additional gap coverage, only the Donut Hole Discount Yes S5617
-215
$3.00$20.00$31.00$82.00
32,172 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 Cigna Medicare Rx Plan One (PDP)
$36.10 $325 No additional gap coverage, only the Donut Hole Discount Yes$0.00$8.00$34.00$83.00tbd members
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 United American - Select (PDP)
$33.50 $320 No additional gap coverage, only the Donut Hole Discount Yes S5755
-077
$3.00$7.00$45.00$95.00
9,572 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 United American - Select (PDP)
$36.60 $325 No additional gap coverage, only the Donut Hole Discount Yes$1.00$4.00$35.00$95.00tbd members
2012 Medco Medicare Prescription Plan - Value (PDP)
$33.40 $320 No additional gap coverage, only the Donut Hole Discount Yes S5660
-108
$4.00$8.0025%40%
41,673 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Express Scripts Medicare - Value (PDP)
$36.90 $325 No additional gap coverage, only the Donut Hole Discount Yes$4.00$6.0025%46%tbd members
2012 AARP MedicareRx Preferred (PDP)
$36.60 $0 No additional gap coverage, only the Donut Hole Discount No S5820
-005
$4.00$8.00$42.00$93.00
186,554 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 AARP MedicareRx Preferred (PDP)
$37.20 $0 No additional gap coverage, only the Donut Hole Discount No$3.00$5.00$40.00$85.00tbd members
2012 First Health Part D Premier (PDP)
$32.70 $250 No additional gap coverage, only the Donut Hole Discount Yes S5768
-009
$6.0019%35%26%
43,244 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 First Health Part D Premier (PDP)
$37.70 $325 No additional gap coverage, only the Donut Hole Discount Yes$1.0025%45% tbd members
2012 HealthSpring Prescription Drug Plan -Reg 6 (PDP)
$35.20 $320 No additional gap coverage, only the Donut Hole Discount Yes S5932
-006
25%25%  
18,271 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2013 HealthSpring Prescription Drug Plan -Reg 6 (PDP)
$38.10 $325 No additional gap coverage, only the Donut Hole Discount Yes25%   tbd members
2012 WellCare Classic (PDP)
$34.90 $320 No additional gap coverage, only the Donut Hole Discount Yes S5967
-143
$0.00$40.00$92.0025%
18,983 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 WellCare Classic (PDP)
$38.50 $0 No additional gap coverage, only the Donut Hole Discount Yes$5.00$43.00$91.0033%tbd members
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 Humana Enhanced (PDP)
$38.10 $0 No additional gap coverage, only the Donut Hole Discount No S5884
-005
$7.00$39.00$74.0033%
46,024 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Humana Enhanced (PDP)
$42.30 $0 No additional gap coverage, only the Donut Hole Discount No$2.00$5.00$42.00$90.00tbd members

-- This plan not offered in 2012 --

S5967
-178
     
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 WellCare Extra (PDP)
$49.10 $0 Many Generics No$0.0025%25%50%tbd members
2012 MedicareRx Rewards Standard (PDP)
$45.80 $320 No additional gap coverage, only the Donut Hole Discount No S5960
-112
$4.00$7.00$32.00$90.00
4,204 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 1 Stars (Poor)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 MedicareRx Rewards Standard (PDP)
$50.60 $325 No additional gap coverage, only the Donut Hole Discount No$2.00$7.00$31.00$85.00tbd members
2012 AmeriHealth Rx Option I (PDP)
$42.10 $320 No additional gap coverage, only the Donut Hole Discount No S2321
-005
25%25%25%25%
7,438 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 AmeriHealth Rx Option I (PDP)
$52.20 $315 No additional gap coverage, only the Donut Hole Discount No$5.00$45.00$85.0025%tbd members
2012 Rite Aid EnvisionRxPlus (PDP)
$69.70 $0 Some Generics No S7694
-077
$0.0020%15%30%
204 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 EnvisionRxPlus Gold (PDP)
$54.00 $150 Some Generics No$2.00$5.00$25.0030%tbd members
2012 United American - Preferred (PDP)
$50.90 $100 No additional gap coverage, only the Donut Hole Discount No S5755
-009
$3.00$9.00$45.00$95.00
3,123 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 United American - Enhanced (PDP)
$56.80 $100 No additional gap coverage, only the Donut Hole Discount No$1.00$1.00$40.00$95.00tbd members
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 BlueRx Plus (PDP)
$58.70 $150 No additional gap coverage, only the Donut Hole Discount No S5593
-002
$8.00$45.00$95.0029%
35,243 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Blue Rx Plus (PDP)
$61.40 $250 No additional gap coverage, only the Donut Hole Discount No$4.00$12.0025%48%tbd members
2012 SecureRx - Option 3 (PDP)
$45.10 $0 No additional gap coverage, only the Donut Hole Discount No S8067
-001
$10.00$51.0033% 
4,461 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 SecureRx - Option 3 (PDP)
$63.80 $0 No additional gap coverage, only the Donut Hole Discount No$6.00$21.00$45.0033%tbd members

-- This plan not offered in 2012 --

S9014
-004
     
new new new  
2013 SecureAdvantage Rx - Option II (PDP)
$64.10 $0 Many Generics No$3.00$10.00$35.00$95.00tbd members

-- This plan not offered in 2012 --

S0064
-041
     
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2013 SmartD Rx Plus (PDP)
$72.40 $0 Some Generics No$0.00$20.00$31.00$85.00tbd members
2012 CIGNA Medicare Rx Plan Two (PDP)
$65.40 $0 Few Generics No S5617
-176
$0.00$5.00$41.00$85.00
1,862 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 Cigna Medicare Rx Plan Two (PDP)
$76.00 $0 Few Generics No$0.00$10.00$45.00$90.00tbd members
2012 AARP MedicareRx Enhanced (PDP)
$87.50 $0 Some Generics No S5921
-093
$4.00$7.00$40.00$76.00
5,367 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 AARP MedicareRx Enhanced (PDP)
$87.30 $0 Some Generics,
Some Brands
No$2.00$5.00$40.00$76.00tbd members
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 First Health Part D Premier Plus (PDP)
$98.70 $0 Some Generics,
Some Brands
No S5670
-036
$0.00$20.0025%43%
5,076 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 First Health Part D Premier Plus (PDP)
$95.10 $0 Some Generics,
Some Brands
No$0.00$20.0025%43%tbd members
2012 Medco Medicare Prescription Plan - Choice (PDP)
$88.90 $150 Many Generics No S5660
-176
$6.00$12.00$45.00$95.00
1,418 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Express Scripts Medicare - Choice (PDP)
$95.40 $200 Many Generics No$8.00$45.00$95.0028%tbd members
2012 CVS Caremark Plus (PDP)
$82.50 $0 No additional gap coverage, only the Donut Hole Discount No S5601
-013
$0.00$40.00$90.0033%
1,917 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 SilverScript Plus (PDP)
$100.60 $0 Many Generics,
Some Brands
No$0.00$34.0035%33%tbd members
2012 Aetna Medicare Rx Premier (PDP)
$86.10 $0 Many Generics No S5810
-176
$4.00$25.00$35.00$80.00
4,222 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 Aetna Medicare Rx Premier (PDP)
$104.50 $0 Many Generics,
Some Brands
No$5.00$33.00$45.00tbdtbd members
2012 MedicareRx Rewards Plus (PDP)
$90.50 $0 Some Generics No S5960
-144
$4.00$7.00$45.00$90.00
1,049 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 1 Stars (Poor)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 MedicareRx Rewards Plus (PDP)
$107.70 $0 Few Generics No$4.00$7.00$45.00$90.00tbd members
2012 Humana Complete (PDP)
$109.40 $0 Many Generics,
Some Brands
No S5884
-034
$5.00$37.00$72.0033%
2,955 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Humana Complete (PDP)
$113.10 $0 Some Generics,
Some Brands
No$5.00$37.00$72.0033%tbd members
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 BlueRx Complete (PDP)
$114.40 $0 Many Generics No S5593
-003
$7.00$40.00$70.0033%
15,448 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 Blue Rx Complete (PDP)
$113.20 $0 Many Generics No$7.00$40.00$70.0033%tbd members
2012 AmeriHealth Rx Option II (PDP)
$87.10 $0 Many Generics No S2321
-002
$5.00$10.00$30.00$65.00
4,612 members
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2013 AmeriHealth Rx Option II (PDP)
$120.70 $0 Many Generics No$5.00$10.00$30.00$65.00tbd members
2012 SecureRx - Option 1 (PDP)
$115.60 $0 Many Generics No S8067
-003
$7.00$40.00$85.0033%
2,455 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  
2013 SecureRx - Option 1 (PDP)
$121.80 $0 Many Generics No$5.00$20.00$40.00$85.00tbd members
2012 BravoRx (PDP)
$36.80 $320 No additional gap coverage, only the Donut Hole Discount No S5998
-005
25%25%25% 
1,963 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  

-- Members will be assigned to HealthSpring Prescription Drug Plan S5932-006 --

     
2012 Health Net Orange Option 1 (PDP)
$34.50 $320 No additional gap coverage, only the Donut Hole Discount Yes S5678
-018
$4.00$44.00$81.0025%
6,499 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  

-- Members will be assigned to SilverScript Basic S5601-012 --

     
2012 Community CCRx Basic (PDP)
$28.70 $320 No additional gap coverage, only the Donut Hole Discount Yes S5803
-075
$2.0025%46%25%
177,056 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  

-- Members will be assigned to SilverScript Basic S5601-012 --

     
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Plan Members
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2012 Health Net Value Orange Option 2 (PDP)
$69.00 $0 No additional gap coverage, only the Donut Hole Discount No S5678
-017
$0.00$32.00$64.0033%
2,652 members
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  

-- Members will be assigned to SilverScript Plus S5601-013 --

     
2012 Community CCRx Choice (PDP)
$78.30 $0 No additional gap coverage, only the Donut Hole Discount No S5803
-143
$0.00$40.00$70.0033%
3,229 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  

-- Members will be assigned to SilverScript Plus S5601-013 --

     
2012 WellCare Signature (PDP)
$58.80 $0 No additional gap coverage, only the Donut Hole Discount No S5967
-040
$0.00$20.00$45.00$85.00
9,069 members
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 3 Stars (Average)  

-- Members will be assigned to WellCare Classic S5967-143 --

     



Chart Legend:

What does all this mean? Below are a few notes to help you understand the 2013 Medicare Part D Plan information above.



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.

» Top
  • 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 the drug’s tier. Plans can form their own tiers, so you should contact the plan or reference their 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.