Eighteen 2015 Medicare Part D plans changed their cost-sharing structure for 2016 prescription drug purchases. These plans include:
For example, the SilverScript Choice plan added a "Preferred Generic" tier as Tier One and the former "Generic" tier will become Tier Two in 2016.
As can be seen in the following example, the 2015 SilverScript Choice plan formulary covered 671 medications as Tier One "Generic" medications (with an $8 co-pay). In comparison, the 2016 SilverScript Choice plan formulary covers 102 medications as Tier One "Preferred Generics" (with an $3 co-pay) and 444 drugs as Tier Two "Generics" (with an $17 co-pay).
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California SilverScript Choice 2015 and 2016 Medicare Part D plan Cost-sharing Comparison |
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| 2015 | 2016 | |||||||
| Monthly Premium | $22.20 | $23.10 | ||||||
| Initial Deductible | $0 | $0 | ||||||
| Gap Coverage | No Gap Coverage | No Gap Coverage | ||||||
| Tier | 2015 Cost-Sharing |
Drugs on Tier |
Tier | 2016 Cost-Sharing |
Drugs on Tier |
|||
| -- | -- | 1 | Preferred Generic | $3 | 102 | |||
| 1 | Generic | $8 | 671 | 2 | Generic | $17 | 444 | |
| 2 | Preferred Brand | $41 | 1,071 | 2 | Preferred Brand | $46 | 924 | |
| 3 | Non-Preferred Brand | 43% | 902 | 3 | Non-Preferred Brand | 47% | 1,076 | |
| 4 | Specialty Tier | 33% | 399 | 4 | Specialty Tier | 33% | 425 | |
| Total Formulary Drugs |
Browse 2015 Formulary | 3,043 | Browse 2016 Formulary |
2,971 | ||||
There were approximately 3,298,354 members in the 2015 SilverScript Choice plan and an additional 124,563 members in the SilverScript Plus plan that are seeing a similar change in their cost-sharing structure.
If you would like to learn how the Generics were sorted between the 2016 Generic and Preferred Generic tiers, you can click here to browser the California SilverScript Choice 2016 Formulary.
To compare annual changes in Medicare plans, our PDP-Compare and MA-Compare tools show the 2015 stand-alone Medicare Part D prescription drug plans (PDPs) and Medicare Advantage plans (MAs or MAPDs) across the country and include changes in plan features such as premium, deductible, cost-sharing and formulary size changes. Our compare tools also highlight plans that were merged, discontinued, or added in 2016.