Q1GROUP LLC | Q1Medicare.com - a non-government resource for the Medicare community
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

Choose Your Medicare Part D Prescription Drug Plan Preferences
 
Scroll down to see plans meeting your criteria.
Only show plans discontinued in 2020
Only show plans new for 2020
2019
2020
2019: $  max: $156
2020: $  max: $192
2019: $  max: $415
2020: $  max: $435
2019:
2020:
2019:
2020:
There are 32 South Dakota Stand-Alone Medicare Part D plans meeting your criteria.
2019 / 2020 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 Total Formulary Drugs
Cust.
Service
Rating
Member
Plan
Exper.
RxCost
Info
Rating
Tier
1
Tier
2
Tier
3
Tier
4

-- This plan not offered in 2019 --

S5884
-204
     
 
2020 Humana Walmart Value Rx Plan (PDP)
$13.20 $435 No additional gap coverage, only the Donut Hole Discount No$1.00$4.00$47.0035%3186
2020 Formulary

-- This plan not offered in 2019 --

S4802
-194
     
 
2020 WellCare Wellness Rx (PDP)
$13.80 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$4.00$40.0047%3469
2020 Formulary

-- This plan not offered in 2019 --

S6946
-051
     
 
2020 Clear Spring Health Premier Rx (PDP)
$14.40 $435 No additional gap coverage, only the Donut Hole Discount No$1.00$3.00$40.0040%3228
2020 Formulary
2019 WellCare Value Script (PDP)
$15.00 $415 No additional gap coverage, only the Donut Hole Discount No S4802
-158
$0.00$6.00$40.0046%
3327
2019 Formulary
 
2020 WellCare Value Script (PDP)
$16.70 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$7.00$43.0047%3469
2020 Formulary
2019 Aetna Medicare Rx Select (PDP)
$17.40 $365 Yes, some additional gap coverage. No S5810
-302
$0.00$2.00$47.0040%
3737
2019 Formulary
 
2020 WellCare Medicare Rx Select (PDP)
$20.70 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$3.00$47.0042%3474
2020 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
2019 Express Scripts Medicare - Saver (PDP)
$25.00 $415 No additional gap coverage, only the Donut Hole Discount No S5660
-241
$1.00$4.0018%30%
2806
2019 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)  
2020 Express Scripts Medicare - Saver (PDP)
$22.00 $435 No additional gap coverage, only the Donut Hole Discount No$1.00$4.00$30.0048%2990
2020 Formulary
2019 Cigna-HealthSpring Rx Secure-Essential (PDP)
$21.90 $415 No additional gap coverage, only the Donut Hole Discount No S5617
-304
$1.00$3.0020%49%
3154
2019 Formulary
 
2020 Cigna-HealthSpring Rx Secure-Essential (PDP)
$22.20 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$2.0018%44%3215
2020 Formulary
2019 Mutual of Omaha Rx Value (PDP)
$30.20 $415 No additional gap coverage, only the Donut Hole Discount No S7126
-057
$1.00$4.0015%32%
2806
2019 Formulary
 
2020 Mutual of Omaha Rx Value (PDP)
$24.50 $435 Yes, some additional gap coverage. No$0.00$2.00$25.0041%2990
2020 Formulary
2019 Journey Rx Value (PDP)
$22.70 $415 No additional gap coverage, only the Donut Hole Discount No S6986
-013
$0.00$1.0015%35%
3006
2019 Formulary
 
2020 Journey Rx Value (PDP)
$26.90 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$1.00$35.0033%3226
2020 Formulary
2019 WellCare Classic (PDP)
$33.80 $415 No additional gap coverage, only the Donut Hole Discount Yes S4802
-089
$0.00$3.00$37.0040%
2989
2019 Formulary
 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)  
2020 WellCare Classic (PDP)
$29.30 $435 No additional gap coverage, only the Donut Hole Discount Yes$0.00$2.00$30.0033%3102
2020 Formulary
2019 Journey Rx Standard (PDP)
$28.00 $415 No additional gap coverage, only the Donut Hole Discount Yes S6986
-007
$2.00$6.0015%32%
2918
2019 Formulary
 
2020 Journey Rx Standard (PDP)
$30.20 $435 No additional gap coverage, only the Donut Hole Discount Yes$2.00$6.00$25.0029%3062
2020 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

-- This plan not offered in 2019 --

S6946
-022
     
 
2020 Clear Spring Health Value Rx (PDP)
$32.40 $435 No additional gap coverage, only the Donut Hole Discount Yes$1.00$3.00$45.0037%3204
2020 Formulary
2019 AARP MedicareRx Saver Plus (PDP)
$33.80 $415 No additional gap coverage, only the Donut Hole Discount Yes S5921
-370
$1.00$6.00$25.0033%
2954
2019 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)  
2020 AARP MedicareRx Saver Plus (PDP)
$32.80 $435 No additional gap coverage, only the Donut Hole Discount Yes$1.00$6.00$28.0035%3118
2020 Formulary
2019 Humana Preferred Rx Plan (PDP)
$31.80 $415 No additional gap coverage, only the Donut Hole Discount Yes S5884
-145
$0.00$1.0025%39%
2968
2019 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)  
2020 Humana Basic Rx Plan (PDP)
$32.90 $435 No additional gap coverage, only the Donut Hole Discount Yes$0.00$1.0025%38%3112
2020 Formulary
2019 SilverScript Choice (PDP)
$32.30 $0 No additional gap coverage, only the Donut Hole Discount Yes S5601
-050
$3.00$12.00$43.0043%
2995
2019 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)  
2020 SilverScript Choice (PDP)
$33.00 $325 No additional gap coverage, only the Donut Hole Discount Yes$0.00$1.00$47.0038%3056
2020 Formulary
2019 Cigna-HealthSpring Rx Secure (PDP)
$58.50 $415 No additional gap coverage, only the Donut Hole Discount No S5617
-123
$1.00$3.00$30.0036%
3191
2019 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)  
2020 Cigna-HealthSpring Rx Secure (PDP)
$33.40 $435 No additional gap coverage, only the Donut Hole Discount Yes$1.00$2.00$30.0033%3254
2020 Formulary
2019 Aetna Medicare Rx Saver (PDP)
$32.40 $310 No additional gap coverage, only the Donut Hole Discount Yes S5810
-059
$1.00$2.00$30.0035%
3283
2019 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)  
2020 WellCare Medicare Rx Saver (PDP)
$34.00 $435 No additional gap coverage, only the Donut Hole Discount Yes$0.00$2.00$28.0038%3198
2020 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
2019 AARP MedicareRx Walgreens (PDP)
$28.10 $415 No additional gap coverage, only the Donut Hole Discount No S5921
-406
$0.00$5.00$30.0032%
2884
2019 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)  
2020 AARP MedicareRx Walgreens (PDP)
$34.10 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$5.00$40.0032%3071
2020 Formulary
2019 EnvisionRxPlus (PDP)
$55.40 $415 No additional gap coverage, only the Donut Hole Discount No S7694
-025
$1.00$3.0015%31%
2987
2019 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)  
2020 EnvisionRxPlus (PDP)
$40.30 $435 No additional gap coverage, only the Donut Hole Discount No$1.00$3.0015%30%3211
2020 Formulary
2019 MedicareBlue Rx Standard (PDP)
$37.90 $415 No additional gap coverage, only the Donut Hole Discount No S5743
-001
$3.00$7.0016%35%
2958
2019 Formulary
 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)  
2020 MedicareBlue Rx Standard (PDP)
$42.00 $435 No additional gap coverage, only the Donut Hole Discount No$3.00$8.00$29.0029%3062
2020 Formulary
2019 Express Scripts Medicare - Value (PDP)
$48.00 $415 No additional gap coverage, only the Donut Hole Discount No S5660
-127
$1.00$3.00$30.0048%
2931
2019 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)  
2020 Express Scripts Medicare - Value (PDP)
$44.50 $435 No additional gap coverage, only the Donut Hole Discount No$1.00$3.00$28.0048%3053
2020 Formulary
2019 Cigna-HealthSpring Rx Secure-Extra (PDP)
$54.40 $100 Yes, some additional gap coverage. No S5617
-270
$4.00$10.00$42.0050%
3317
2019 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)  
2020 Cigna-HealthSpring Rx Secure-Extra (PDP)
$49.20 $100 Yes, some additional gap coverage. No$4.00$10.00$42.0050%3389
2020 Formulary
2019 Humana Walmart Rx Plan (PDP)
$25.60 $415 No additional gap coverage, only the Donut Hole Discount No S5884
-171
$1.00$4.0020%35%
3055
2019 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)  
2020 Humana Premier Rx Plan (PDP)
$52.80 $435 No additional gap coverage, only the Donut Hole Discount No$1.00$4.00$42.0044%3272
2020 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
2019 Mutual of Omaha Rx Plus (PDP)
$47.00 $415 No additional gap coverage, only the Donut Hole Discount No S7126
-024
$3.00$5.00$21.0048%
3187
2019 Formulary
 
2020 Mutual of Omaha Rx Plus (PDP)
$58.70 $435 No additional gap coverage, only the Donut Hole Discount No$0.00$5.00$42.0048%3315
2020 Formulary
2019 AARP MedicareRx Preferred (PDP)
$69.50 $0 No additional gap coverage, only the Donut Hole Discount No S5820
-024
$5.00$10.00$40.0040%
3367
2019 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)  
2020 AARP MedicareRx Preferred (PDP)
$71.00 $0 No additional gap coverage, only the Donut Hole Discount No$5.00$10.00$45.0040%3555
2020 Formulary
2019 Aetna Medicare Rx Value Plus (PDP)
$58.80 $0 Yes, some additional gap coverage. No S5768
-148
$1.00$2.00$47.0050%
3737
2019 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)  
2020 WellCare Medicare Rx Value Plus (PDP)
$72.40 $0 No additional gap coverage, only the Donut Hole Discount No$1.00$4.00$47.0050%3474
2020 Formulary
2019 SilverScript Plus (PDP)
$68.20 $0 Yes, some additional gap coverage. No S5601
-051
$1.00$5.00$35.0040%
3011
2019 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)  
2020 SilverScript Plus (PDP)
$75.30 $0 Yes, some additional gap coverage. No$0.00$2.00$47.0050%3108
2020 Formulary
2019 Express Scripts Medicare - Choice (PDP)
$94.30 $350 Yes, some additional gap coverage. No S5660
-195
$2.00$7.00$42.0048%
3268
2019 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)  
2020 Express Scripts Medicare - Choice (PDP)
$85.60 $250 Yes, some additional gap coverage. No$2.00$7.00$42.0048%3291
2020 Formulary
2019 MedicareBlue Rx Premier (PDP)
$89.70 $0 Yes, some additional gap coverage. No S5743
-004
$0.00$0.0017%45%
2958
2019 Formulary
 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)  
2020 MedicareBlue Rx Premier (PDP)
$89.60 $0 Yes, some additional gap coverage. No$0.00$0.0017%40%3062
2020 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
2019 Humana Enhanced (PDP)
$71.20 $0 No additional gap coverage, only the Donut Hole Discount No S5884
-083
$5.00$10.00$47.0050%
3174
2019 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)  

-- Members will be assigned to Humana Premier Rx Plan (PDP) S5884-171 --

     
2019 SilverScript Allure (PDP)
$80.00 $0 No additional gap coverage, only the Donut Hole Discount No S5601
-167
$1.00$5.0020%40%
3011
2019 Formulary
 

-- Members will be assigned to SilverScript Choice (PDP) S5601-050 --

     
2019 WellCare Extra (PDP)
$75.20 $0 No additional gap coverage, only the Donut Hole Discount No S4802
-121
$0.00$5.00$40.0046%
3327
2019 Formulary
 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)  

-- Members will be assigned to WellCare Medicare Rx Value Plus (PDP) S5768-148 --

     



Chart Legend:

What does all this mean? Below are a few notes to help you understand the 2020 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 initial deductible is $435. 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: In the CMS Standard Plan, the beneficiary, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $5,019 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2020, all formulary drugs will have at least a 75% discount in the coverage gap (Donut Hole). The Gap Coverage Types discussed in this section are supplemental coverage your plan pays in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
    • No Gap Coverage: You receive the 75% Donut Hole Discount and pay up to $5,019 depending on your mix of generics and brand-name drugs, before exiting into Catastrophic Coverage. Read more...
    • Yes: This plan offers some supplemental gap coverage in addition to the 75% Donut Hole Discount. See plan details for a description of the gap coverage. The description may read similar to: Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.

  • $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 - This is what you will pay for formulary drugs in 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: July 2020 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: July 2020 figures) - This is the total number of member for this plan in all CMS Regions (States) combined.

  • Initial Coverage Limit (ICL) - The Initial Coverage 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 2020 is $4,020 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. You should always verify cost and coverage information with your Medicare plan provider.