10 Things to Know About Medicare Part D Coverage and Costs in 2019
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Table 1: Top Firms Offering Medicare Part D Plans Ranked by 2019 Enrollment |
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| Name of firm | 2019 Enrollment | Percent of total Part D enrollment |
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| PDP | MA-PD | Total | ||
| UnitedHealth Group | 5,108,180 | 5,215,144 | 10,323,324 | 23% |
| Humana | 4,299,086 | 3,473,709 | 7,772,795 | 17% |
| CVS Health | 5,979,883 | 1,602,402 | 7,582,285 | 17% |
| WellCare Health Plans | 4,015,902 | 531,189 | 4,547,091 | 10% |
| Cigna | 3,237,013 | 433,296 | 3,670,309 | 8% |
| BCBS* | 998,355 | 2,037,224 | 3,035,579 | 7% |
| Kaiser Permanente | – | 1,575,636 | 1,575,636 | 4% |
| Anthem BCBS | 428,699 | 647,159 | 1,075,858 | 2% |
| Total, top firms | 24,067,118 | 15,515,759 | 39,582,877 | 88% |
| Total Part D | 25,152,764 | 19,773,155 | 44,925,919 | 100% |
| NOTE: PDP is prescription drug plan. MA-PD is Medicare Advantage prescription drug plan. Includes enrollment in the territories and employer group plans. Number may not sum to total due to rounding. *BCBS excludes Anthem BCBS, which is a separate plan sponsor. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2019 Part D plan files. |
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Table 2: Medicare Part D Cost-Sharing Amounts by Plan Type and Formulary Tier, 2019 |
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| PDP | MA-PD | |||||
| Formulary tier | Minimum | Median | Maximum | Minimum | Median | Maximum |
| Preferred generic | $0 | $1 | $10 | $0 | $2 | $15 |
| Generic | $0 | $5 | $20 | $0 | $10 | $20 |
| Preferred brand copayments | $19 | $40 | $47 | $0 | $47 | $47 |
| Preferred brand coinsurance | 10% | 20% | 25% | 15% | 22% | 25% |
| Non-preferred drug copayments | $70 | $70 | $93 | $5 | $99 | $100 |
| Non-preferred drug coinsurance | 25% | 40% | 50% | 24% | 45% | 50% |
| Specialty | 25% | 25% | 33% | 25% | 31% | 33% |
| NOTE: PDP is prescription drug plan. MA-PD is Medicare Advantage prescription drug plan. Cost-sharing amounts are weighted by enrollment. Excludes enrollees in employer-only group plans and Special Needs Plans. Excludes plans with missing data. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2019 Part D plan files. |
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