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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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There are 28 North Dakota 2019 stand-alone Medicare Part D plans meeting your criteria.

Caution: The 2019 Medicare Part D plan information below is for research purposes.
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2019 Medicare Part D Plan Information
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Plan Name Monthly
Prem.
Deduct-
ible
(Donut Hole)
Additional
Gap
Coverage
$0 Prem.
with Full
LIS?
Preferred Pharmacy
Copay/
Coinsurance
30-Day Supply
Total Formulary Drugs
Cust.
Service
Rating
Member
Plan
Exper.
RxCost
Info
Rating
WellCare Value Script (PDP)
Benefit Details
           
$15.00 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $6.00
Preferred Brand: $40.00
Non-Preferred Drug: 46%
Specialty Tier: 25%
3,396

Browse Formulary
WellCare Value Script (PDP) Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) WellCare Value Script (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) WellCare Value Script (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Aetna Medicare Rx Select (PDP)
Benefit Details
           
$17.40 $365
Tier 1 and 2 exempt
Yes, some additional gap coverage. NoPreferred Generic: $0.00
Generic: $2.00
Preferred Brand: $47.00
Non-Preferred Drug: 40%
Specialty Tier: 25%
3,827

Browse Formulary
Aetna Medicare Rx Select (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Rx Select (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Rx Select (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Cigna-HealthSpring Rx Secure-Essential (PDP)
Benefit Details
           
$21.90 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: 20%
Non-Preferred Drug: 49%
Specialty Tier: 25%
3,239

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Cigna-HealthSpring Rx Secure-Essential (PDP) Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Cigna-HealthSpring Rx Secure-Essential (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna-HealthSpring Rx Secure-Essential (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
Journey Rx Value (PDP)
Benefit Details
           
$22.70 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $1.00
Preferred Brand: 15%
Non-Preferred Drug: 35%
Specialty Tier: 25%
3,076

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Journey Rx Value (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Journey Rx Value (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Journey Rx Value (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Express Scripts Medicare - Saver (PDP)
Benefit Details
           
$25.00 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: 18%
Non-Preferred Drug: 30%
Specialty Tier: 25%
2,906

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Express Scripts Medicare - Saver (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Express Scripts Medicare - Saver (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Express Scripts Medicare - Saver (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Humana Walmart Rx Plan (PDP)
Benefit Details
           
$25.60 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: 20%
Non-Preferred Drug: 35%
Specialty Tier: 25%
3,181

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Humana Walmart Rx Plan (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Walmart Rx Plan (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Humana Walmart Rx Plan (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Journey Rx Standard (PDP)
Benefit Details
           
$28.00 $415 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $2.00
Generic: $6.00
Preferred Brand: 15%
Non-Preferred Drug: 32%
Specialty Tier: 25%
2,993

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Journey Rx Standard (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Journey Rx Standard (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Journey Rx Standard (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
AARP MedicareRx Walgreens (PDP)
Benefit Details
           
$28.10 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $30.00
Non-Preferred Drug: 32%
Specialty Tier: 25%
3,025

Browse Formulary
AARP MedicareRx Walgreens (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareRx Walgreens (PDP) Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) AARP MedicareRx Walgreens (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Mutual of Omaha Rx Value (PDP)
Benefit Details
           
$30.20 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: 15%
Non-Preferred Drug: 32%
Specialty Tier: 25%
2,906

Browse Formulary
new new new Higher cost-sharing at standard network pharmacies Details:
Humana Preferred Rx Plan (PDP)
Benefit Details
           
$31.80 $415 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $0.00
Generic: $1.00
Preferred Brand: 25%
Non-Preferred Drug: 39%
Specialty Tier: 25%
3,095

Browse Formulary
Humana Preferred Rx Plan (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Preferred Rx Plan (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Humana Preferred Rx Plan (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
SilverScript Choice (PDP)
Benefit Details
           
$32.30 $0 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $43.00
Non-Preferred Drug: 43%
Specialty Tier: 33%
3,061

Browse Formulary
SilverScript Choice (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) SilverScript Choice (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) SilverScript Choice (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Aetna Medicare Rx Saver (PDP)
Benefit Details
           
$32.40 $310
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $1.00
Generic: $2.00
Preferred Brand: $30.00
Non-Preferred Drug: 35%
Specialty Tier: 27%
3,366

Browse Formulary
Aetna Medicare Rx Saver (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Rx Saver (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Rx Saver (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
AARP MedicareRx Saver Plus (PDP)
Benefit Details
           
$33.80 $415 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $1.00
Generic: $6.00
Preferred Brand: $25.00
Non-Preferred Drug: 33%
Specialty Tier: 25%
3,072

Browse Formulary
AARP MedicareRx Saver Plus (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareRx Saver Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) AARP MedicareRx Saver Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
WellCare Classic (PDP)
Benefit Details
           
$33.80 $415
Tier 1 exempt
No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $0.00
Generic: $3.00
Preferred Brand: $37.00
Non-Preferred Drug: 40%
Specialty Tier: 25%
3,061

Browse Formulary
WellCare Classic (PDP) Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) WellCare Classic (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) WellCare Classic (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
MedicareBlue Rx Standard (PDP)
Benefit Details
           
$37.90 $415
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $3.00
Generic: $7.00
Preferred Brand: 16%
Non-Preferred Drug: 35%
Specialty Tier: 25%
3,029

Browse Formulary
MedicareBlue Rx Standard (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) MedicareBlue Rx Standard (PDP) Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) MedicareBlue Rx Standard (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies Details:
Mutual of Omaha Rx Plus (PDP)
Benefit Details
           
$47.00 $415 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $3.00
Generic: $5.00
Preferred Brand: $21.00
Non-Preferred Drug: 48%
Specialty Tier: 25%
3,300

Browse Formulary
new new new Higher cost-sharing at standard network pharmacies Details:
Express Scripts Medicare - Value (PDP)
Benefit Details
           
$48.00 $415 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: $30.00
Non-Preferred Drug: 48%
Specialty Tier: 25%
3,022

Browse Formulary
Express Scripts Medicare - Value (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Express Scripts Medicare - Value (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Express Scripts Medicare - Value (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Cigna-HealthSpring Rx Secure-Extra (PDP)
Benefit Details
           
$54.40 $100
Tier 1, 2, 3 and 6 exempt
Yes, some additional gap coverage. NoPreferred Generic: $4.00
Generic: $10.00
Preferred Brand: $42.00
Non-Preferred Drug: 50%
Specialty Tier: 31%
Select Care Drugs: $6.00
3,398

Browse Formulary
Cigna-HealthSpring Rx Secure-Extra (PDP) Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Cigna-HealthSpring Rx Secure-Extra (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna-HealthSpring Rx Secure-Extra (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
EnvisionRxPlus (PDP)
Benefit Details
           
$55.40 $415 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: 15%
Non-Preferred Drug: 31%
Specialty Tier: 25%
3,138

Browse Formulary
EnvisionRxPlus (PDP) Medicare Part D Plan Customer Service Rating - 3 Stars (Average) EnvisionRxPlus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EnvisionRxPlus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
Cigna-HealthSpring Rx Secure (PDP)
Benefit Details
           
$58.50 $415 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: $30.00
Non-Preferred Drug: 36%
Specialty Tier: 25%
3,273

Browse Formulary
Cigna-HealthSpring Rx Secure (PDP) Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Cigna-HealthSpring Rx Secure (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna-HealthSpring Rx Secure (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Aetna Medicare Rx Value Plus (PDP)
Benefit Details
           
$58.80 $0 Yes, some additional gap coverage. NoPreferred Generic: $1.00
Generic: $2.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%
3,827

Browse Formulary
Aetna Medicare Rx Value Plus (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Rx Value Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Aetna Medicare Rx Value Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
SilverScript Plus (PDP)
Benefit Details
           
$68.20 $0 Yes, some additional gap coverage. NoPreferred Generic: $1.00
Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Drug: 40%
Specialty Tier: 33%
3,081

Browse Formulary
SilverScript Plus (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) SilverScript Plus (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) SilverScript Plus (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
AARP MedicareRx Preferred (PDP)
Benefit Details
           
$69.50 $0 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $5.00
Generic: $10.00
Preferred Brand: $40.00
Non-Preferred Drug: 40%
Specialty Tier: 33%
3,529

Browse Formulary
AARP MedicareRx Preferred (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareRx Preferred (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) AARP MedicareRx Preferred (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Humana Enhanced (PDP)
Benefit Details
           
$71.20 $0 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $5.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%
3,291

Browse Formulary
Humana Enhanced (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Enhanced (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Humana Enhanced (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Extra (PDP)
Benefit Details
           
$75.20 $0 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $40.00
Non-Preferred Drug: 46%
Specialty Tier: 33%
3,396

Browse Formulary
WellCare Extra (PDP) Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) WellCare Extra (PDP) Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) WellCare Extra (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
SilverScript Allure (PDP)
Benefit Details
           
$80.00 $0 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $5.00
Preferred Brand: 20%
Non-Preferred Drug: 40%
Specialty Tier: 33%
3,081

Browse Formulary
SilverScript Allure (PDP) Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) SilverScript Allure (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) SilverScript Allure (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
MedicareBlue Rx Premier (PDP)
Benefit Details
           
$89.70 $0 Yes, some additional gap coverage. NoPreferred Generic: $0.00
Generic: $0.00
Preferred Brand: 17%
Non-Preferred Drug: 45%
Specialty Tier: 33%
3,029

Browse Formulary
MedicareBlue Rx Premier (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) MedicareBlue Rx Premier (PDP) Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) MedicareBlue Rx Premier (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies Details:
Express Scripts Medicare - Choice (PDP)
Benefit Details
           
$94.30 $350
Tier 1 and 2 exempt
Yes, some additional gap coverage. NoPreferred Generic: $2.00
Generic: $7.00
Preferred Brand: $42.00
Non-Preferred Drug: 48%
Specialty Tier: 26%
3,364

Browse Formulary
Express Scripts Medicare - Choice (PDP) Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Express Scripts Medicare - Choice (PDP) Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Express Scripts Medicare - Choice (PDP) Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
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Chart Legend:

Below are a few notes to help with the understanding of the 2019 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.

  • 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 $415. 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, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $3,834 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2019, ALL formulary generics will have at least a 63% discount and ALL brand-name drugs will have at least a 75% 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 pay up to $3,834 depending on your mix of generics and brand-name drugs. Read more...
    • Yes: This plan offers some level of gap coverage. See plan details for a description of the gap coverage. It will 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 - 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 2019 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 2019 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 2019 is $3,820 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.