Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2021
| Table 1: Medicare Part D Stand-alone Prescription Drug Plans, Benchmark Plans, Insulin Model Plans, and Monthly Premiums, 2020 and 2021 | |||||||||
| Number of PDPs |
Number of
Benchmark PDPs
|
Number of
Insulin
Model PDPs
|
Weighted Average
PDP Monthly Premium
|
||||||
| State/territory | 2020 | 2021 | 2020 | 2021 | 2021 | 2020 | 2021 | ||
| U.S. Total | 948 | 996 | 244 | 259 | 308 | $38 | $41 | ||
| Alabama | 30 | 32 | 7 | 8 | 10 | $42 | $44 | ||
| Alaska | 24 | 25 | 7 | 7 | 9 | $36 | $38 | ||
| Arizona | 31 | 32 | 12 | 10 | 9 | $37 | $41 | ||
| Arkansas | 27 | 31 | 6 | 7 | 9 | $34 | $36 | ||
| California | 32 | 32 | 8 | 7 | 9 | $40 | $42 | ||
| Colorado | 26 | 27 | 7 | 8 | 9 | $36 | $41 | ||
| Connecticut | 25 | 27 | 7 | 8 | 9 | $42 | $46 | ||
| Delaware | 27 | 27 | 10 | 9 | 9 | $39 | $42 | ||
| District of Columbia | 27 | 27 | 10 | 9 | 9 | $35 | $37 | ||
| Florida | 27 | 28 | 4 | 5 | 10 | $41 | $45 | ||
| Georgia | 28 | 32 | 6 | 8 | 9 | $35 | $39 | ||
| Hawaii | 25 | 26 | 5 | 5 | 9 | $31 | $34 | ||
| Idaho | 28 | 28 | 8 | 9 | 9 | $35 | $39 | ||
| Illinois | 28 | 31 | 8 | 10 | 9 | $38 | $42 | ||
| Indiana | 28 | 30 | 7 | 8 | 9 | $35 | $37 | ||
| Iowa | 29 | 28 | 8 | 7 | 9 | $33 | $41 | ||
| Kansas | 28 | 29 | 6 | 7 | 9 | $33 | $36 | ||
| Kentucky | 28 | 30 | 7 | 8 | 9 | $35 | $36 | ||
| Louisiana | 26 | 26 | 9 | 8 | 9 | $37 | $39 | ||
| Maine | 26 | 28 | 6 | 7 | 9 | $37 | $42 | ||
| Maryland | 27 | 27 | 10 | 9 | 9 | $37 | $40 | ||
| Massachusetts | 25 | 27 | 7 | 8 | 9 | $40 | $44 | ||
| Michigan | 30 | 29 | 9 | 9 | 9 | $37 | $40 | ||
| Minnesota | 29 | 28 | 8 | 7 | 9 | $34 | $42 | ||
| Mississippi | 25 | 27 | 7 | 7 | 9 | $33 | $35 | ||
| Missouri | 28 | 29 | 5 | 6 | 9 | $36 | $38 | ||
| Montana | 29 | 28 | 8 | 7 | 9 | $34 | $39 | ||
| Nebraska | 29 | 28 | 8 | 7 | 9 | $32 | $38 | ||
| Nevada | 28 | 29 | 5 | 7 | 9 | $36 | $39 | ||
| New Hampshire | 26 | 28 | 6 | 7 | 9 | $36 | $42 | ||
| New Jersey | 28 | 30 | 8 | 7 | 9 | $44 | $46 | ||
| New Mexico | 26 | 27 | 7 | 7 | 9 | $34 | $36 | ||
| New York | 27 | 28 | 9 | 7 | 8 | $45 | $47 | ||
| North Carolina | 28 | 31 | 9 | 9 | 9 | $38 | $41 | ||
| North Dakota | 29 | 28 | 8 | 7 | 9 | $32 | $37 | ||
| Ohio | 28 | 30 | 2 | 5 | 9 | $34 | $38 | ||
| Oklahoma | 29 | 30 | 8 | 9 | 9 | $38 | $40 | ||
| Oregon | 28 | 29 | 8 | 9 | 9 | $34 | $40 | ||
| Pennsylvania | 31 | 33 | 10 | 10 | 10 | $38 | $43 | ||
| Rhode Island | 25 | 27 | 7 | 8 | 9 | $39 | $43 | ||
| South Carolina | 28 | 29 | 5 | 5 | 9 | $38 | $42 | ||
| South Dakota | 29 | 28 | 8 | 7 | 9 | $31 | $37 | ||
| Tennessee | 30 | 32 | 7 | 8 | 10 | $37 | $39 | ||
| Texas | 30 | 35 | 5 | 8 | 9 | $35 | $38 | ||
| Utah | 28 | 28 | 8 | 9 | 9 | $37 | $41 | ||
| Vermont | 25 | 27 | 7 | 8 | 9 | $38 | $42 | ||
| Virginia | 29 | 30 | 7 | 7 | 9 | $35 | $39 | ||
| Washington | 28 | 29 | 8 | 9 | 9 | $36 | $42 | ||
| West Virginia | 31 | 33 | 10 | 10 | 10 | $40 | $44 | ||
| Wisconsin | 30 | 31 | 9 | 9 | 9 | $39 | $41 | ||
| Wyoming | 29 | 28 | 8 | 7 | 9 | $38 | $44 | ||
| Puerto Rico | 6 | 6 | — | — | 2 | $51 | $60 | ||
| American Samoa | 1 | 1 | — | — | 0 | $43 | $58 | ||
| Guam | 2 | 2 | — | — | 0 | $45 | $51 | ||
| Northern Mariana Islands | 1 | 1 | — | — | 0 | $30 | $46 | ||
| U.S. Virgin Islands | 1 | 1 | — | — | 0 | $47 | $70 | ||
| NOTE: PDP is prescription drug plan. U.S. total counts exclude PDPs in the territories, while weighted average includes territories. Average monthly premium is weighted by September 2020 enrollment for the region in which the state is located. Benchmark plan counts include “de minimis” plans, which can retain Low-Income Subsidy beneficiaries despite exceeding the benchmark premium by a minimal amount (up to $2 in 2021). Benchmark plans are not shown for the territories because the LIS is not available to residents of the territories. Insulin model plans are not shown for 2020 because the model is new in 2021.
SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2020-2021 Part D plan files. |
|||||||||
| Table 2: National Medicare Part D Stand-alone Prescription Drug Plans in 2021 | ||||||||||
| Enrollment1 | Weighted average monthly premium2 | |||||||||
| Plan Name | Type of plan | Benchmark plan |
Insulin
model plan
|
Number
(in millions)
|
% of total |
Top 10
in 2020
|
2020 | 2021 | $ change | % change |
| All PDPs | 20.2 | 100% | $38 | $41 | $3 | 9% | ||||
| AARP MedicareRx Preferred | Enhanced | No | Yes3 | 2 | 10.1% | 2 | $79 | $89 | $10 | 12% |
| AARP MedicareRx Saver Plus | Basic | Yes3 | No | 1.2 | 5.9% | 5 | $32 | $33 | $1 | 2% |
| AARP MedicareRx Walgreens | Enhanced | No | No | 0.7 | 3.5% | $34 | $35 | $1 | 3% | |
| Cigna Secure Rx | Basic | Yes3 | No | 0.5 | 2.7% | $30 | $29 | $0 | -2% | |
| Cigna Secure-Essential Rx | Enhanced | No | No | 0.2 | 1.0% | $22 | $24 | $2 | 7% | |
| Cigna Secure-Extra Rx | Enhanced | No | Yes | 0.2 | 0.7% | $56 | $50 | -$7 | -12% | |
| Elixir RxPlus* | Basic | Yes4 | No | 0.8 | 3.9% | 9 | $22 | $23 | $1 | 6% |
| Express Scripts Medicare – Choice | Enhanced | No | Yes | <0.1 | 0.2% | $83 | $75 | -$8 | -9% | |
| Express Scripts Medicare – Saver | Enhanced | No | Yes | 0.2 | 1.0% | $24 | $26 | $2 | 6% | |
| Express Scripts Medicare – Value | Basic | Yes3 | No | 0.4 | 1.8% | $36 | $33 | -$2 | -7% | |
| Humana Basic Rx Plan | Basic | Yes3 | No | 1.5 | 7.2% | 3 | $31 | $31 | $0 | 0% |
| Humana Premier Rx Plan | Enhanced | No | Yes | 1.4 | 7.1% | 4 | $58 | $65 | $7 | 13% |
| Humana Walmart Value Rx Plan | Enhanced | No | No | 0.8 | 4.0% | 7 | $13 | $17 | $4 | 30% |
| SilverScript Choice | Basic | Yes3 | No | 4 | 19.9% | 1 | $29 | $28 | -$1 | -2% |
| SilverScript SmartRx | Enhanced | No | No | New in 2020 | $75 | |||||
| WellCare Classic | Basic | Yes3 | No | 1.1 | 5.3% | 6 | $29 | $28 | -$1 | -4% |
| WellCare Medicare Rx Saver | Basic | Yes3 | No | 0.8 | 3.9% | 8 | $30 | $32 | $1 | 4% |
| WellCare Medicare Rx Select | Enhanced | No | No | 0.7 | 3.3% | $20 | $24 | $4 | 22% | |
| WellCare Medicare Rx Value Plus | Enhanced | No | Yes | 0.4 | 2.2% | $72 | $76 | $4 | 6% | |
| WellCare Value Script | Enhanced | No | Yes | 0.8 | 3.8% | 10 | $17 | $17 | $0 | 1% |
| WellCare Wellness Rx | Enhanced | No | Yes | 0.6 | 3.2% | $14 | $16 | $2 | 12% | |
| NOTE: PDP is prescription drug plan. Analysis excludes enrollees in employer group plans. *Called EnvisionRx Plus in 2020. 1Enrollment as of March 2020, includes enrollees with and without low-income subsidies. Top 10 in 2020 based on March 2020 enrollment. 2Weighted by September 2020 enrollment, assumes current PDP enrollees remain in their same plan, and makes no assumptions about plan choices by new enrollees for 2021. 3In most regions. 4In some regions. 5Unweighted median because PDP is new for 2020.
SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2020-2021 Part D plan files. |
||||||||||
| Table 3: Median Standard Cost-Sharing Amounts in National Medicare Part D Stand-alone Prescription Drug Plans in 2021 | ||||||||||
| Preferred Generics | Generics | Preferred Brands 1 | Non-preferred drugs | Specialty tier drugs | ||||||
| Plan name | 2020 | 2021 | 2020 | 2021 | 2020 | 2021 | 2020 | 2021 | 2020 | 2021 |
| ALL PDPs | $0 | $0 | $4 | $5 | $42/25% | $40/19% | 38% | 40% | 25% | 25% |
| AARP MedicareRx Preferred | $5 | $5 | $10 | $10 | $45 | $45 | 40% | 40% | 33% | 33% |
| AARP MedicareRx Saver Plus | $1 | $1 | $6 | $6 | $26 | $32 | 35% | 40% | 25% | 25% |
| AARP MedicareRx Walgreens | $0 | $0 | $5 | $6 | $40 | $40 | 32% | 40% | 25% | 25% |
| Cigna Secure-Essential Rx | $0 | $0 | $2 | $2 | 18% | 18% | 43% | 47% | 25% | 25% |
| Cigna Secure-Extra Rx | $4 | $4 | $10 | $10 | $42 | $42 | 50% | 50% | 31% | 31% |
| Cigna Secure Rx | $1 | $1 | $2 | $2 | $30 | $35 | 36% | 50% | 25% | 25% |
| Elixir RxPlus | $1 | $1 | $3 | $6 | $35/15% | $43/15%2 | 35% | 45% | 25% | 25% |
| Express Scripts Medicare – Choice | $2 | $2 | $7 | $7 | $42 | $42 | 48% | 50% | 28% | 31% |
| Express Scripts Medicare – Saver | $1 | $2 | $4 | $7 | $30 | $35 | 47% | 50% | 25% | 28% |
| Express Scripts Medicare – Value | $1 | $1 | $3 | $3 | $25 | $24 | 35% | 49% | 25% | 25% |
| Humana Basic Rx Plan | $0 | $0 | $1 | $1 | 25% | 20% | 38% | 34% | 25% | 25% |
| Humana Premier Rx Plan | $1 | $1 | $4 | $4 | $42 | $45 | 44% | 49% | 25% | 25% |
| Humana Walmart Value Rx Plan | $1 | $1 | $4 | $4 | $47 | 18% | 35% | 35% | 25% | 25% |
| SilverScript Choice | $0 | $0 | $1 | $5 | $47 | $35 | 38% | 40% | 27% | 27% |
| SilverScript SmartRx | n/a | $0 | n/a | $19 | n/a | $46 | n/a | 48% | n/a | 25% |
| WellCare Classic | $0 | $0 | $2 | $2 | $32 | $30 | 34% | 34% | 25% | 25% |
| WellCare Medicare Rx Saver | $0 | $0 | $2 | $4 | $28 | $38 | 38% | 37% | 25% | 25% |
| WellCare Medicare Rx Select | $0 | $0 | $3 | $3 | $47 | $47 | 42% | 42% | 25% | 25% |
| WellCare Medicare Rx Value Plus | $1 | $1 | $4 | $4 | $47 | $47 | 47% | 47% | 33% | 33% |
| WellCare Value Script | $0 | $0 | $7 | $7 | $43 | $43 | 47% | 47% | 25% | 25% |
| WellCare Wellness Rx | $0 | $0 | $5 | $5 | $40 | $40 | 46% | 46% | 25% | 25% |
| NOTE: PDP is prescription drug plan. Estimates are weighted medians for those plans that vary cost sharing by region (weighted by September 2020 enrollment). n/a is not applicable because plan is new for 2020. 1Approximately 81% of September 2020 enrollees are in plans with a preferred brand copay and 19% are in plans with a preferred brand coinsurance. 2Based on September 2020 enrollment, 53% of Elixir RxPlus enrollees will pay copays and 47% will pay coinsurance for preferred brand drugs.
SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2020-2021 Part D plan files. |
||||||||||