Your Medicare Part D plan's cost-sharing structure (how the plan's formulary is divided into drug tiers and the cost-sharing per tier) directly influences your medication costs. When a new drug tier is added into the cost-sharing design, the drugs on the prior year's drug tiers are moved -- some to lower costing tiers and others to higher costing tiers. For example, the 2016 EnvisionRxPlus Silver (PDP) plan added a "Preferred Generic" tier as tier one and the former
"Generic" tier is now tier two in the renamed 2017 EnvisionRxPlus (PDP) plan.
As can be seen in the following example, the 2016 EnvisionRxPlus Silver (PDP) plan formulary covered 1,093 medications as tier one "Generic" medications (with a $2 co-pay).
In comparison, the 2017 EnvisionRxPlus (PDP) plan formulary covers 166 medications as tier one "Preferred Generics" (with an $1 co-pay) and 671 drugs as tier two "Generics" (with an $15 co-pay).
Pennsylvania EnvisionRxPlus (PDP) plan
2016 and 2017 Medicare Part D plan Cost-sharing Comparison
|
|
2016 |
2017 |
Monthly Premium |
$33.30 |
$14.60 |
Initial Deductible |
$360 |
$260 Tiers 1 and 2 exempt |
Gap Coverage |
No Gap Coverage |
No Gap Coverage |
Tier |
2016
Cost-Sharing |
Drugs
on Tier |
Tier |
2017
Cost-Sharing |
Drugs
on Tier |
-- |
-- |
|
|
1 |
Preferred Generic |
$1
|
166 |
1 |
Generic |
$2 |
1,093 |
2 |
Generic |
$15 |
671 |
2 |
Preferred Brand |
10% |
448 |
3 |
Preferred Brand |
10% |
221 |
3 |
Non-Preferred Brand |
40% |
1,101 |
4 |
Non-Preferred Brand |
25% |
1,305 |
4 |
Specialty Tier |
25% |
432 |
5 |
Specialty Tier |
27% |
536 |
Total Formulary Drugs
|
Browse 2016 Formulary |
3,074 |
|
Browse 2017
Formulary |
2,899 |
Please note, there are approximately 283,804 EnvisionRxPlus (PDP) plan members across the country who are seeing this change in their cost-sharing structure.
If you would like to learn how the 2016 Generics were sorted between the 2017 Generic and Preferred Generic tiers, you
can
click
here to browser the Pennsylvania EnvisionRxPlus 2017 Formulary.
To compare annual changes in Medicare plans, our
PDP-Compare shows the changes in all 2016 stand-alone Medicare Part D prescription drug plans (PDPs) for 2017 and our
MA-Compare shows the changes in all 2016 Medicare Advantage plans (MAs or MAPDs) for 2017. Both tools 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 2017.