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.

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