Medicare Part D: A First Look at Prescription Drug Plans in 2019
| Table 1: Medicare Part D Stand-alone Prescription Drug Plans, Benchmark Plans, and Monthly Premiums, 2018 and 2019 | ||||||
| Number of PDPs | Number of Benchmark PDPs | Weighted Average PDP Monthly Premium | ||||
| State/territory | 2018 | 2019 | 2018 | 2019 | 2018 | 2019 |
| U.S. Total | 782 | 901 | 216 | 215 | $40.57 | $41.21 |
| Alabama | 25 | 29 | 6 | 6 | $41.77 | $41.10 |
| Alaska | 19 | 22 | 7 | 7 | $38.66 | $38.32 |
| Arizona | 23 | 28 | 10 | 10 | $41.45 | $41.42 |
| Arkansas | 23 | 26 | 4 | 4 | $32.21 | $35.87 |
| California | 25 | 30 | 5 | 7 | $44.30 | $45.63 |
| Colorado | 24 | 26 | 6 | 7 | $40.28 | $40.78 |
| Connecticut | 22 | 26 | 7 | 7 | $40.43 | $41.91 |
| Delaware | 21 | 25 | 10 | 9 | $39.14 | $39.66 |
| District of Columbia | 21 | 25 | 10 | 9 | $39.14 | $39.66 |
| Florida | 21 | 27 | 2 | 2 | $44.11 | $44.76 |
| Georgia | 24 | 26 | 5 | 4 | $37.69 | $38.80 |
| Hawaii | 20 | 24 | 4 | 4 | $32.91 | $33.53 |
| Idaho | 25 | 26 | 8 | 8 | $41.25 | $41.48 |
| Illinois | 24 | 27 | 8 | 7 | $42.11 | $41.20 |
| Indiana | 24 | 26 | 7 | 7 | $38.24 | $39.18 |
| Iowa | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Kansas | 23 | 26 | 4 | 4 | $39.54 | $41.15 |
| Kentucky | 24 | 26 | 7 | 7 | $38.24 | $39.18 |
| Louisiana | 21 | 26 | 6 | 8 | $36.38 | $38.51 |
| Maine | 24 | 26 | 7 | 7 | $41.46 | $40.84 |
| Maryland | 21 | 25 | 10 | 9 | $39.14 | $39.66 |
| Massachusetts | 22 | 26 | 7 | 7 | $40.43 | $41.91 |
| Michigan | 24 | 29 | 9 | 9 | $38.97 | $38.71 |
| Minnesota | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Mississippi | 20 | 24 | 6 | 5 | $34.98 | $36.54 |
| Missouri | 24 | 26 | 4 | 4 | $38.79 | $40.90 |
| Montana | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Nebraska | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Nevada | 24 | 26 | 3 | 3 | $40.42 | $38.69 |
| New Hampshire | 24 | 26 | 7 | 7 | $41.46 | $40.84 |
| New Jersey | 22 | 26 | 7 | 6 | $46.83 | $45.79 |
| New Mexico | 24 | 27 | 7 | 7 | $32.17 | $35.34 |
| New York | 20 | 23 | 8 | 8 | $45.27 | $45.77 |
| North Carolina | 24 | 28 | 7 | 7 | $41.35 | $40.98 |
| North Dakota | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Ohio | 23 | 26 | 6 | 7 | $38.29 | $40.47 |
| Oklahoma | 23 | 28 | 7 | 7 | $40.95 | $42.82 |
| Oregon | 22 | 26 | 7 | 7 | $38.74 | $38.82 |
| Pennsylvania | 26 | 30 | 9 | 9 | $40.67 | $41.20 |
| Rhode Island | 22 | 26 | 7 | 7 | $40.43 | $41.91 |
| South Carolina | 22 | 26 | 4 | 3 | $37.09 | $39.35 |
| South Dakota | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Tennessee | 25 | 29 | 6 | 6 | $41.77 | $41.10 |
| Texas | 24 | 27 | 7 | 5 | $39.20 | $38.65 |
| Utah | 25 | 26 | 8 | 8 | $41.25 | $41.48 |
| Vermont | 22 | 26 | 7 | 7 | $40.43 | $41.91 |
| Virginia | 24 | 27 | 6 | 6 | $42.17 | $42.11 |
| Washington | 22 | 26 | 7 | 7 | $38.74 | $38.82 |
| West Virginia | 26 | 30 | 9 | 9 | $40.67 | $41.20 |
| Wisconsin | 25 | 28 | 8 | 8 | $42.11 | $42.44 |
| Wyoming | 23 | 28 | 5 | 6 | $35.53 | $37.02 |
| Puerto Rico | 6 | 6 | — | — | $44.06 | $42.32 |
| American Samoa | 1 | 1 | — | — | $5.80 | $34.70 |
| Guam | 3 | 2 | — | — | $34.85 | $39.85 |
| Northern Mariana Islands | 2 | 1 | — | — | $24.80 | $37.20 |
| U.S. Virgin Islands | 1 | 1 | — | — | $41.30 | $42.60 |
| NOTE: PDP is prescription drug plan. U.S. total count excludes PDPs in the territories. Totals include sanctioned plans closed to new enrollees as of September of prior year. Average monthly premium is weighted by September 2018 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 2019). Benchmark plans are not shown for the territories because the LIS is not available to residents of the territories. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2018-2019 Part D plan files. |
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| Table 2: Enrollment and Premiums for Top 10 PDPs with the Highest Enrollment, 2018 and 2019 | ||||||
| Name of PDP | Type of plan | September 2018 enrollment (# in millions) | Weighted average monthly premium | Percent change | ||
| # | % of total | 2018 | 2019 | 2018-2019 | ||
| SilverScript Choice | Basic | 4.55 | 22.1% | $26.34 | $30.73 | 17% |
| AARP MedicareRx Preferred | Enhanced* | 2.46 | 12.0 | $83.56 | $74.76 | -11 |
| Humana Walmart | Enhanced | 2.44 | 11.8 | $20.20 | $27.67 | 37 |
| Humana Preferred | Basic | 1.64 | 8.0 | $31.16 | $31.10 | — |
| AARP MedicareRx Saver Plus | Basic | 1.39 | 6.7 | $35.49 | $34.06 | -4 |
| Aetna Medicare Rx Saver | Basic | 1.18 | 5.8 | $29.61 | $29.20 | -1 |
| WellCare Classic | Basic | 0.99 | 4.8 | $30.41 | $31.65 | 4 |
| Humana Enhanced | Enhanced | 0.76 | 3.7 | $75.83 | $75.89 | — |
| AARP MedicareRx Walgreens | Enhanced | 0.65 | 3.1 | $26.99 | $28.07 | 4 |
| Aetna Medicare Rx Value Plus | Enhanced | 0.57 | 2.8 | $57.46 | $60.16 | 5 |
| TOTAL FOR ALL PDPS | 20.58 | 100% | $40.57 | $41.21 | 2% | |
| NOTE: PDP is prescription drug plan. Plan names can change from year to year; plans are designated the same if they have the same contract/plan ID. Analysis excludes enrollees in employer group plans. Average premiums are weighted by September 2018 enrollment. “—“ means a premium increase/decrease of less than half of one percentage point. *AARP MedicareRx Preferred is a basic PDP in the territories. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2018-2019 Part D plan files. |
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| Table 3: Benefit Designs and Deductibles in Medicare Part D Stand-alone Prescription Drugs Plans, 2018 and 2019 | ||
| 2018 | 2019 | |
| Share of PDPs offering | ||
| Basic benefits | 47% | 39% |
| Enhanced benefits | 53% | 61% |
| Standard deductible | 52% | 52% |
| Lower deductible | 11% | 19% |
| No deductible | 37% | 29% |
| Weighted average monthly PDP premium | ||
| Basic benefits | $30.90 | $32.35 |
| Enhanced benefits | $54.68 | $54.13 |
| Standard deductible | $29.84 | $31.82 |
| Lower deductible | $33.34 | $33.15 |
| No deductible | $55.07 | $54.50 |
| NOTE: PDP is prescription drug plan. Average premiums are weighted by September 2018 enrollment. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2018-2019 Part D plan files. |
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| Table 4: Median Cost Sharing (Copayments or Coinsurance Rates) for all Medicare Part D Stand-alone Prescription Drug Plans and Top 10 PDPs with the Highest Enrollment, 2018 and 2019 | ||||||||||
| Name of PDP | Preferred generics | Generics | Preferred brands* | Non-preferred drugs | Specialty drugs | |||||
| 2018 | 2019 | 2018 | 2019 | 2018 | 2019 | 2018 | 2019 | 2018 | 2019 | |
| Median for all PDPs | $1 | $1 | $6 | $5 | $37/21% | $40/20% | 40% | 40% | 26% | 26% |
| Top 10 PDPs | ||||||||||
| SilverScript Choice | $3 | $3 | $14 | $13 | $42 | $42 | 46% | 45% | 33% | 33% |
| AARP MedicareRx Preferred | $5 | $5 | $12 | $10 | $37 | $40 | 40% | 40% | 33% | 33% |
| Humana Walmart Rx | $1 | $1 | $4 | $4 | 23% | 20% | 35% | 35% | 25% | 25% |
| Humana Preferred Rx | $0 | $0 | $1 | $1 | 20% | 25% | 35% | 37% | 25% | 25% |
| AARP MedicareRx Saver Plus | $1 | $1 | $3 | $6 | $33 | $25 | 30% | 33% | 25% | 25% |
| Aetna Medicare Rx Saver | $1 | $1 | $2 | $2 | $30 | $30 | 35% | 35% | 26% | 27% |
| WellCare Classic | $0 | $0 | $1 | $2 | $35 | $37 | 42% | 41% | 25% | 25% |
| Humana Enhanced | $3 | $5 | $7 | $10 | $42 | $47 | 44% | 50% | 33% | 33% |
| AARP MedicareRx Walgreens | $0 | $0 | $6 | $5 | $31 | $30 | 32% | 32% | 25% | 25% |
| Aetna Medicare Rx Value Plus | $1 | $1 | $2 | $2 | $47 | $47 | 50% | 47% | 33% | 33% |
| NOTE: PDP is prescription drug plan. Estimates are weighted medians for those plans that vary cost sharing by region (weighted by September 2018 enrollment). *Approximately 77% of September 2018 enrollees are in plans with a preferred brand copay and 23% are in plans with a preferred brand coinsurance. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2018-2019 Part D plan files. |
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