Q1Medicare.com
Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community
  • ☰ MENU
  • Home
  • Contact
  • MAPD
  • PDP
  • 2017
  • FAQs
  • Latest Medicare News

PDP-Compare Tutorial

This tutorial explains how to search and compare Medicare Part D plans using PDP-Compare. The examples are for plan years 2014 / 2015 but apply to all years.


One-Click Comparison

PDP-Compare offers what we call a One-Click Comparison of Medicare Part D Plans.
By simply selecting your state and clicking on the "Click to Compare Annual Plan Changes" button, you can compare:
  • Plan Quality Ratings,
  • Premium,
  • Deductible,
  • Type of Coverage during the Doughnut Hole,
  • $0 Qualification for Low-Income Subsidy (LIS) Recipients
  • Cost Sharing - Copayments, Co-insurance, and
  • Popularity (Past Enrollment Figures)



How to Search using PDP-Compare

PDP-Compare Search Criteria

Most states offer 30 or more Medicare Part D plans. Sometimes it helps to reduce the number of plans that you want to compare. This section explains the search and sort options in PDP-Compare.
The Search Criteria are divided into three areas:
  • Those applying to the plan independent of the plan year
  • Criteria to be used against the 2014 plans
  • Criteria to be used against the 2015 plans


Criteria that are used independent of the plan year include:
  • State - this is a required field. You must select a state.
  • Plan Family - If you are only interested in certain plans, ex: AARP, then just select the family of plans from the drop-down list.
  • Other Options - click the checkbox to show only those plans that will be discontinued in 2015.
  • Sort Results by - Premiums, Plan name, Plan rating, Popularity (Enrollment)

Criteria that apply to a particular plan year must be entered in the appropriate column for the year (2014 or 2015) the search criteria include:
  • Maximum Premium - Which plans under $25 in 2014 are still under $25 in 2015? - enter 25 in the 2014 column and 25 in the 2015 column (Answer: in California, only one of the plans that was under $25 in 2014 is still under $25 in 2015. Remove the $25 from the 2014 column to see that an additional nine plans will be under $25 in CA for 2015.
  • Maximum Deductible - is used just as maximum premium is above.
  • Type of Gap Coverage - is used just as maximum premium is above, except you select an option in the appropriate column 2014 or 2015 fields.
  • Full Low-Income Subsidy? - Choose one of the three options: Yes, show only plans that qualify, No, I receive no or only partial extra help, or Only show Plans that DO NOT qualify for $0 Premium. This option is used if you would like to see only plans which changed their qualification status. Example: select Yes... in the 2014 column and Only show Plans that DO NOT qualify ... in the 2015 column. You will see that in California, three plans no longer qualify for the LIS $0 Premium status. Switch the 2014 and 2015 criteria to see that one new plan qualifies in 2015 that did not qualify in 2014.


Example 1: Changes in Current Plan

Example 1: Changes in Current Plan

In this example our New York beneficiary wants to see what changes they can expect in their current plan. We have selected New York as our state. Note that State is the only field that must be entered prior to a search. Since the beneficiary is only interested in Humana Plans, we can narrow down the comparison by selecting Humana in the Plan Family field. We have left the Full Low-Income Subsidy (LIS) field set to No... so that we will see plans which qualify and also those that do not qualify. Then click on "Click to Compare Annual Plan Changes"

The comparison of the three Humana plans is shown for both 2014 and 2015. Our beneficiary can quickly see that the 2014 Humana Walmart Rx and Preferred plans will remain fairly consistent for 2015 except for the increase in plan premiums. The Humana Enhanced will see changes in copayments for Tiers 1 through 3 and Tier 4 cost-sharing will change from a $92.00 copayment to 44% co-insurance.


Example 2: 2014 Plan no longer offered in 2015

Example 2: 2014 Plan no longer offered in 2015

This California beneficiary wants to know which plans will no longer be offered in 2015. They enter California in the State field (a required field) and click the checkbox next to Only Show Plans that will be Discontinued in 2015. They can leave the rest of the search fields empty and then click on Click to Compare Annual Plan Changes.

Our beneficiary can quickly see details of the seven (7) plans that will no longer be offered in California for 2015. They can also see that members of the AARP MedicareRx Enhanced, Cigna-HealthSpring Rx, First Health Part D Premier Plus and Essentails plans, SilverScript Choice, and SmartD Rx Plus plans will be automatically re-assigned to other plans unless they choose a new plan for themselves (details can be found in the Annual Notice of Change sent directly to members by the carrier).

Our California beneficiary can change the additional information field to "Members in this State" to see how many people in California are currently enrolled in plans that will be discontinued in 2015.



Example 3: Change in Plan Coverage from 2014 to 2015

Example 3: Change in Plan Coverage from 2013 to 2014

In this example our North Carolina beneficiary wants to see what changes they can expect in their current plan. We have selected North Carolina as our state. Note that state is the only field that must be entered prior to a search. Since the beneficiary is only interested in SilverScript plans, we can narrow down the comparison by selecting SilverScript in the Plan Family field. We have left all other criteria fields empty. Then click on "Click to Compare Annual Plan Changes"

The comparison of the two SilverScript plans is shown for both 2014 and 2015. Our beneficiary can see that if the stay with their 2014 SilverScript Basic plan for 2015, their plan will now be called SilverScript Choice plan and they will have a $0 deductible. Their premium will be about $5 lower and their cost-sharing will be higher.


Example 4: Advanced Search - Comparing Plans from Different Companies.

Example 4: Advanced Search - Comparing Plans from Different Companies.

Our Arizona beneficiary wants to find a medium priced Medicare Part D plan and wishes to compare plans across different companies. Since there are 38 rows in the Arizona comparison, this list could be a bit cumbersome. Our beneficiary does not want to spend more than $35 per month and does not want to pay a deductible.

This type of search is done by first selecting the State Arizona, and then entering our value 35 in the Maximum Premium field in the 2015 column and 0 in the Maximum Deductible field in the 2015 column. Since we want a medium priced plan and have entered our max, lets let the low priced plan fall to the bottom of the list by selecting 2015 Premium Highest to Lowest in the Sort Results by field. Then click on "Click to Compare Annual Plan Changes"

Our comparison is reduced to only two plans rather than 38.

We can quickly compare the CMS Quality Rating, Premiums, Copays and Coinsurance, and even Plan Popularity across these plans. We can even see the individual plan changes from 2014 to 2015.



Advanced Search in California

Example 5: Advanced Search - Premium increases in California

In this example our California beneficiary wants to see the changes in the most inexpensive Medicare Part D plans. We enter California in the State field, 35 in the 2014 Maximum Premium field, 310 in the 2014 Maximum Deductible field (or leave it blank since $310 is the 2014 maximum deductible. We entered 40 in the 2015 Maximum Premium field, 320 in the 2015 Maximum Deductible field (or leave it blank since $320 is the 2015 maximum deductible. We changed the Sort Results by field to 2015 Premium Highest to Lowest.

Our comparison shows 11 plans that meet our search criteria. Only two plans lowered their premiums, one will be discontinued, and the remaining eight will raise their premiums. Three of the plans no longer qualify for the LIS $0 premium. One plan continues to be sanctioned by CMS and cannot accept new enrollments. The co-payments/co-insurance for all plans can quickly be compared to determine which plan best matches the prescription purchase patterns for the beneficiary.



Chart Key: What do all of the Chart Fields Mean?

Below is a key or legend for the PDP-Compare Comparison Chart. The same key is shown just after the PDP-Compare Chart once you click on the Search button.

Click the +1 button if you have found this page useful:  

Medicare Supplements
fill the gaps in your
Original Medicare
1. Select Your State:
» Medicare Supplement FAQs






.



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.