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This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

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2016
2017
2016: $  max: $175
2017: $  max: $179
2016: $  max: $360
2017: $  max: $400
2016:
2017:
2016:
2017:
There are 30 California Stand-Alone Medicare Part D plans meeting your criteria.
2016 / 2017 Medicare Part D Plan Information
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Plan Name Monthly
Premium
Deduct-
ible
(Donut Hole)
Additional
Gap
Coverage
$0
Prem.
with
Full
LIS?
Plan
ID
Cost-Sharing Total Formulary Drugs
Cust.
Service
Rating
Member
Plan
Exper.
RxCost
Info
Rating
Tier
1
Tier
2
Tier
3
Tier
4
2016 Humana Walmart Rx Plan (PDP)
$18.40 $360 No additional gap coverage, only the Donut Hole Discount No S5884
-178
$1.00$4.0020%35%
3533
2016 Formulary
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2017 Humana Walmart Rx Plan (PDP)
$17.00 $400 No additional gap coverage, only the Donut Hole Discount No$1.00$4.0020%35%3375
2017 Formulary
2016 Symphonix PrimeSaver Rx (PDP)
$39.30 $200 No additional gap coverage, only the Donut Hole Discount No S0522
-065
$1.00$6.0020%40%
3731
2016 Formulary
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2017 AARP MedicareRx Walgreens (PDP)
$22.40 $400 No additional gap coverage, only the Donut Hole Discount No$0.00$3.00$27.0032%3000
2017 Formulary
2016 Humana Preferred Rx Plan (PDP)
$27.30 $360 No additional gap coverage, only the Donut Hole Discount Yes S5884
-114
$1.00$2.0020%35%
3449
2016 Formulary
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2017 Humana Preferred Rx Plan (PDP)
$28.20 $400 No additional gap coverage, only the Donut Hole Discount Yes$0.00$1.0020%35%3286
2017 Formulary
2016 SilverScript Choice (PDP)
$23.10 $0 No additional gap coverage, only the Donut Hole Discount Yes S5601
-064
$3.00$17.00$46.0047%
3128
2016 Formulary
 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)  
2017 SilverScript Choice (PDP)
$29.90 $0 No additional gap coverage, only the Donut Hole Discount Yes$3.00$17.00$47.0048%3073
2017 Formulary
2016 Symphonix Value Rx (PDP)
$27.30 $360 No additional gap coverage, only the Donut Hole Discount Yes S0522
-034
$1.00$2.0020%33%
3696
2016 Formulary
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2017 Symphonix Value Rx (PDP)
$30.60 $400 No additional gap coverage, only the Donut Hole Discount Yes$1.00$2.00$26.0033%3029
2017 Formulary
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Total Drugs
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2016 Aetna Medicare Rx Saver (PDP)
$24.80 $360 No additional gap coverage, only the Donut Hole Discount Yes S5810
-066
$1.00$2.00$35.0040%
3336
2016 Formulary
 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)  
2017 Aetna Medicare Rx Saver (PDP)
$32.10 $400 No additional gap coverage, only the Donut Hole Discount Yes$1.00$2.00$30.0038%3340
2017 Formulary
2016 AARP MedicareRx Saver Plus (PDP)
$31.00 $360 No additional gap coverage, only the Donut Hole Discount Yes S5921
-376
$1.00$2.00$21.0030%
3365
2016 Formulary
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2017 AARP MedicareRx Saver Plus (PDP)
$33.40 $400 No additional gap coverage, only the Donut Hole Discount Yes$1.00$2.00$21.0030%3211
2017 Formulary

-- This plan not offered in 2016 --

S4802
-094
     
 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)  
2017 WellCare Classic (PDP)
$34.90 $400 No additional gap coverage, only the Donut Hole Discount Yes$0.00$14.00$46.0048%2971
2017 Formulary
2016 First Health Part D Value Plus (PDP)
$37.60 $0 Yes, some additional gap coverage. No S5768
-155
$1.00$7.00$47.0050%
3388
2016 Formulary
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2017 First Health Part D Value Plus (PDP)
$42.30 $0 Yes, some additional gap coverage. No$2.00$5.00$47.0050%3395
2017 Formulary
2016 Cigna-HealthSpring Rx Secure-Extra (PDP)
$77.40 $250 No additional gap coverage, only the Donut Hole Discount No S5617
-277
$1.00$5.0020%43%
3551
2016 Formulary
 Medicare Part D Plan Rating - 1 Stars (Poor)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2017 Cigna-HealthSpring Rx Secure-Extra (PDP)
$46.60 $50 Yes, some additional gap coverage. No$5.00$10.00$42.0050%3541
2017 Formulary
2016 EnvisionRxPlus Silver (PDP)
$32.00 $360 No additional gap coverage, only the Donut Hole Discount Yes S7694
-032
$2.0010%40%25%
3074
2016 Formulary
 Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2017 EnvisionRxPlus (PDP)
$53.90 $400 No additional gap coverage, only the Donut Hole Discount No10%12%15%34%3029
2017 Formulary
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Total Drugs
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2016 Cigna-HealthSpring Rx Secure (PDP)
$59.80 $360 No additional gap coverage, only the Donut Hole Discount No S5617
-158
$3.00$5.0015%47%
3538
2016 Formulary
 Medicare Part D Plan Rating - 1 Stars (Poor)  Medicare Part D Plan Rating - 3 Stars (Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  
2017 Cigna-HealthSpring Rx Secure (PDP)
$58.10 $400 No additional gap coverage, only the Donut Hole Discount No$2.00$7.00$40.0041%351
2017 Formulary
2016 Express Scripts Medicare - Value (PDP)
$60.60 $360 No additional gap coverage, only the Donut Hole Discount No S5660
-134
$0.00$11.0022%48%
3534
2016 Formulary
 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)  
2017 Express Scripts Medicare - Value (PDP)
$59.10 $400 No additional gap coverage, only the Donut Hole Discount No$0.00$3.00$42.0048%3347
2017 Formulary

-- This plan not offered in 2016 --

S4802
-128
     
 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)  
2017 WellCare Extra (PDP)
$67.50 $0 No additional gap coverage, only the Donut Hole Discount No$0.00$8.00$31.0045%2914
2017 Formulary
2016 Anthem Blue Cross MedicareRx Standard (PDP)
$45.20 $360 No additional gap coverage, only the Donut Hole Discount No S5596
-033
$1.00$5.00$29.0035%
2983
2016 Formulary
 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)  
2017 Anthem Blue Cross MedicareRx Standard (PDP)
$68.20 $400 No additional gap coverage, only the Donut Hole Discount No$1.00$5.00$32.0040%3068
2017 Formulary
2016 Humana Enhanced (PDP)
$73.20 $0 Yes, some additional gap coverage. No S5884
-030
$3.00$7.00$42.0044%
3910
2016 Formulary
 Medicare Part D Plan Rating - 4 Stars (Above Average)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2017 Humana Enhanced (PDP)
$71.10 $0 Yes, some additional gap coverage. No$3.00$7.00$42.0044%3662
2017 Formulary
2016 Blue Shield Medicare Basic Plan (PDP)
$55.10 $360 No additional gap coverage, only the Donut Hole Discount No S2468
-003
$0.00$6.00$40.0033%
3397
2016 Formulary
 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)  
2017 Blue Shield Medicare Basic Plan (PDP)
$82.40 $400 No additional gap coverage, only the Donut Hole Discount No$2.00$6.00$40.0028%3274
2017 Formulary
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Total Drugs
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2016 SilverScript Plus (PDP)
$90.90 $0 Yes, some additional gap coverage. No S5601
-065
$0.00$3.00$22.0035%
3128
2016 Formulary
 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)  
2017 SilverScript Plus (PDP)
$83.70 $0 Yes, some additional gap coverage. No$0.00$3.00$27.0040%3079
2017 Formulary
2016 AARP MedicareRx Preferred (PDP)
$68.60 $0 No additional gap coverage, only the Donut Hole Discount No S5820
-031
$4.00$10.00$35.0040%
3591
2016 Formulary
 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)  
2017 AARP MedicareRx Preferred (PDP)
$86.00 $0 No additional gap coverage, only the Donut Hole Discount No$4.00$10.00$35.0037%3487
2017 Formulary
2016 Express Scripts Medicare - Choice (PDP)
$100.10 $360 No additional gap coverage, only the Donut Hole Discount No S5660
-202
$1.00$5.00$42.0035%
3683
2016 Formulary
 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)  
2017 Express Scripts Medicare - Choice (PDP)
$91.40 $350 No additional gap coverage, only the Donut Hole Discount No$2.00$7.0023%48%3510
2017 Formulary
2016 Anthem Blue Cross MedicareRx Plus (PDP)
$81.70 $0 Yes, some additional gap coverage. No S5596
-034
$1.00$3.00$40.0038%
3224
2016 Formulary
 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)  
2017 Anthem Blue Cross MedicareRx Plus (PDP)
$106.00 $0 Yes, some additional gap coverage. No$1.00$3.00$40.0039%3266
2017 Formulary
2016 First Health Part D Premier Plus (PDP)
$91.90 $0 Yes, some additional gap coverage. No S5768
-194
$1.00$2.00$40.0045%
3701
2016 Formulary
 Medicare Part D Plan Rating - 5 Stars (Excellent)  Medicare Part D Plan Rating - 2 Stars (Below Average)  Medicare Part D Plan Rating - 3 Stars (Average)  
2017 First Health Part D Premier Plus (PDP)
$120.70 $0 Yes, some additional gap coverage. No$1.00$2.00$34.0050%3812
2017 Formulary
2016 Blue Shield Medicare Enhanced Plan (PDP)
$100.50 $0 No additional gap coverage, only the Donut Hole Discount No S2468
-004
$4.00$10.00$40.0038%
3655
2016 Formulary
 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)  
2017 Blue Shield Medicare Enhanced Plan (PDP)
$129.30 $0 No additional gap coverage, only the Donut Hole Discount No$4.00$10.00$40.0027%3579
2017 Formulary
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Total Drugs
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2016 Anthem Blue Cross MedicareRx Gold (PDP)
$132.00 $0 Yes, some additional gap coverage. No S5596
-035
$0.00$3.00$25.0035%
3678
2016 Formulary
 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)  
2017 Anthem Blue Cross MedicareRx Gold (PDP)
$159.80 $0 Yes, some additional gap coverage. No$0.00$3.00$25.0035%3703
2017 Formulary
2016 United American - Select (PDP)
$71.10 $360 No additional gap coverage, only the Donut Hole Discount No S5755
-103
$0.00$3.0017%27%
2916
2016 Formulary
 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 SilverScript Choice (PDP) S5601-064 --

     
2016 United American - Essential (PDP)
$43.50 $230 No additional gap coverage, only the Donut Hole Discount No S5755
-133
$0.00$5.00$39.0040%
3187
2016 Formulary
 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 SilverScript Choice (PDP) S5601-064 --

     
2016 United American - Enhanced (PDP)
$88.20 $270 Yes, some additional gap coverage. No S5755
-035
$0.00$7.00$37.0040%
4322
2016 Formulary
 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 SilverScript Plus (PDP) S5601-065 --

     
2016 WellCare Classic (PDP)
$40.80 $360 No additional gap coverage, only the Donut Hole Discount No S5967
-169
$0.00$20.00$47.0050%
2964
2016 Formulary
 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 WellCare Classic (PDP) S4802-094 --

     
2016 WellCare Extra (PDP)
$74.40 $0 No additional gap coverage, only the Donut Hole Discount No S5967
-203
$0.00$10.00$31.0045%
2964
2016 Formulary
 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 WellCare Extra (PDP) S4802-128 --

     
Plan Name Monthly
Premium
Deduct-
ible
Additional
Gap
Coverage
$0 Prem.
Full LIS?
Plan
ID
Cost-Sharing Total Drugs
Service Exper. Cost Info Tier 1 Tier 2 Tier 3 Tier 4
2016 Transamerica MedicareRx Classic (PDP)
$131.50 $360 No additional gap coverage, only the Donut Hole Discount No S9579
-031
$0.00$10.0025%30%
3209
2016 Formulary
 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)  

-- This plan not offered in 2017 --

     



Chart Legend:

What does all this mean? Below are a few notes to help you understand the 2017 Medicare Part D Plan information above.

  • 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.

  • 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.)

    (Search Tip: If you have selected an amount in the "LIS Subsidy Amount" filed, the premium shown is the premium based on your Low-Income Subsidy selection.

  • Deductible: The standard CMS plan deductible is $400. Many Medicare plans do not have a deductible, however their plan 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.) Some plans that have an annual deductible exempt certain drug tiers from the deductible. For example, "Tier 1 exempt" may be shown. This would mean that Tier 1 drugs purchased during the Deductible phase, would not fall into the deductible and would be charged the Initial Coverage phase tier 1 cost-sharing.

  • Gap Coverage: the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3,725 in drug costs (the Donut Hole). The Healthcare Reform provides that for Plan Year 2017, ALL formulary generics will have at least a 49% discount and ALL brand drugs will have at least a 60% 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 $3,725;
    • Yes: This plan offers some level of gap coverage.

  • $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.

  • 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. 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.

  • Plan’s Summary Star Rating - This is the overall star rating for the Medicare Part D plan. To learn more about the star ratings, please see our Plan Quality Star Ratings.

  • 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: September 2017 figures) - This is the total number of members in this plan for this PDP CMS Region. For regions that contain more than one state, this is the total for all of those states combined. If the CMS Region contains more than one state, the actual state enrollment is shown, along with the CMS region and national enrollment figures on the plan details page. you can access the plan details by clicking the plan name, orange enroll options button, or the plan details icon.

  • Members Nation Wide (updated: September 2017 figures) - This is the total number of member for this plan in all CMS Regions (States) combined.

  • 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 2017 is $3,700 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.