Filling the need for trusted information on national health issues…

Medicare Part D: A First Look at Plan Offerings in 2016

Appendix 1: Information about PDPs by State

Table A1: Number of PDPs by State, 2006-2016
STATE/TERRITORY 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2015-2016 change
U.S. Total 1,429 1,875 1,824 1,689 1,576 1,109 1,041 1,031 1,169 1,001 886 -115
Alabama 41 56 53 49 46 34 32 33 35 30 27 -3
Alaska 27 45 47 45 41 29 25 23 28 24 19 -5
Arizona 43 53 51 49 46 30 30 29 34 30 26 -4
Arkansas 40 58 55 52 49 34 30 30 34 29 26 -3
California 47 55 56 51 47 33 33 32 36 32 28 -4
Colorado 43 55 55 53 48 31 28 29 34 30 26 -4
Connecticut 44 51 51 47 48 34 30 30 33 27 26 -1
Delaware 47 55 52 48 45 33 31 29 36 27 24 -3
District of Columbia 47 55 52 48 45 33 31 29 36 27 24 -3
Florida 43 57 58 54 49 32 33 34 35 27 22 -5
Georgia 42 55 54 50 45 32 30 30 34 30 27 -3
Hawaii 29 46 49 47 41 28 25 23 29 25 21 -4
Idaho 44 56 54 51 48 35 33 32 37 31 28 -3
Illinois 42 56 53 49 46 35 33 32 38 33 28 -5
Indiana 42 53 52 48 44 32 31 31 35 31 28 -3
Iowa 41 53 52 48 46 33 33 32 34 30 26 -4
Kansas 40 53 52 48 46 33 31 30 33 29 25 -4
Kentucky 42 53 52 48 44 32 31 31 35 31 28 -3
Louisiana 39 52 50 47 45 32 30 30 33 28 25 -3
Maine 41 53 53 46 43 30 28 28 32 28 27 -1
Maryland 47 55 52 48 45 33 31 29 36 27 24 -3
Massachusetts 44 51 51 47 48 34 30 30 33 27 26 -1
Michigan 40 54 55 51 46 35 34 33 36 31 28 -3
Minnesota 41 53 52 48 46 33 33 32 34 30 26 -4
Mississippi 38 52 49 47 45 32 30 29 33 28 24 -4
Missouri 41 53 52 48 45 32 30 31 35 31 28 -3
Montana 41 53 52 48 46 33 33 32 34 30 26 -4
Nebraska 41 53 52 48 46 33 33 32 34 30 26 -4
Nevada 44 54 53 49 46 31 29 29 34 32 28 -4
New Hampshire 41 53 53 46 43 30 28 28 32 28 27 -1
New Jersey 44 57 57 52 47 33 30 29 34 29 25 -4
New Mexico 43 57 55 50 47 32 30 30 36 31 27 -4
New York 46 61 55 51 50 33 29 28 31 25 22 -3
North Carolina 38 51 52 49 47 33 30 30 34 29 26 -3
North Dakota 41 53 52 48 46 33 33 32 34 30 26 -4
Ohio 43 60 58 49 46 34 33 33 37 31 27 -4
Oklahoma 42 56 52 49 46 33 30 30 36 31 27 -4
Oregon 45 57 55 48 44 32 30 30 35 30 26 -4
Pennsylvania 52 66 63 57 55 38 36 38 39 29 29 0
Rhode Island 44 51 51 47 48 34 30 30 33 27 26 -1
South Carolina 45 59 56 53 47 34 32 31 35 31 27 -4
South Dakota 41 53 52 48 46 33 33 32 34 30 26 -4
Tennessee 41 56 53 49 46 34 32 33 35 30 27 -3
Texas 47 60 56 53 50 33 33 32 36 32 28 -4
Utah 44 56 54 51 48 35 33 32 37 31 28 -3
Vermont 44 51 51 47 48 34 30 30 33 27 26 -1
Virginia 41 53 52 48 44 32 30 31 35 31 28 -3
Washington 45 57 55 48 44 32 30 30 35 30 26 -4
West Virginia 52 66 63 57 55 38 36 38 39 29 29 0
Wisconsin 45 54 57 53 48 32 29 30 33 29 27 -2
Wyoming 41 53 52 48 46 33 33 32 34 30 26 -4
TERRITORY                    
American Samoa 1 3 4 4 3 2 1 1 1 1 1 0
Guam 1 3 4 4 3 2 1 1 1 2 2 0
Northern Mariana Islands 1 3 4 4 3 2 1 1 1 1 1 0
Puerto Rico 10 28 34 33 29 17 16 16 13 7 6 -1
Virgin Islands 4 6 7 7 6 4 3 1 1 1 1 0
NOTE: PDP is prescription drug plan. Analysis for 2016 includes 91 plans under CMS sanction and closed to new enrollees as of September 2015.
SOURCE: Georgetown/Kaiser Family Foundation analysis of CMS PDP crosswalk and landscape source files.
Table A2: Monthly Premiums for PDPs by State, 2016
STATE/TERRITORY Minimum Premium Maximum Premium Weighted Average Premium % Change, 2015-2016
U.S. Total $11.40 $174.70 $41.46 13%
Alabama $18.40 $117.20 $42.16 16%
Alaska $18.40 $90.20 $42.53 19%
Arizona $18.40 $109.70 $39.99 24%
Arkansas $11.40 $131.90 $34.59 -1%
California $18.40 $132.00 $41.96 13%
Colorado $18.40 $140.20 $41.38 14%
Connecticut $18.40 $127.60 $39.66 13%
Delaware $18.40 $87.10 $41.35 15%
District of Columbia $18.40 $87.10 $41.35 15%
Florida $18.40 $174.70 $45.31 21%
Georgia $18.40 $135.50 $40.44 17%
Hawaii $18.40 $80.10 $34.91 17%
Idaho $18.40 $162.10 $44.17 9%
Illinois $18.40 $157.40 $42.90 16%
Indiana $18.40 $130.20 $40.64 11%
Iowa $18.40 $124.20 $36.69 3%
Kansas $18.40 $125.20 $41.75 15%
Kentucky $18.40 $130.20 $40.64 11%
Louisiana $16.80 $106.10 $35.95 7%
Maine $18.40 $119.30 $38.71 17%
Maryland $18.40 $87.10 $41.35 15%
Massachusetts $18.40 $127.60 $39.66 13%
Michigan $18.40 $117.50 $42.55 11%
Minnesota $18.40 $124.20 $36.69 3%
Mississippi $17.30 $119.20 $37.05 7%
Missouri $18.40 $124.10 $38.42 10%
Montana $18.40 $124.20 $36.69 3%
Nebraska $18.40 $124.20 $36.69 3%
Nevada $18.40 $134.40 $40.06 16%
New Hampshire $18.40 $119.30 $38.71 17%
New Jersey $18.40 $104.70 $49.61 17%
New Mexico $12.00 $152.70 $29.70 12%
New York $18.40 $93.40 $43.15 13%
North Carolina $18.40 $120.50 $43.01 12%
North Dakota $18.40 $124.20 $36.69 3%
Ohio $18.40 $128.00 $39.58 13%
Oklahoma $18.40 $163.80 $41.83 11%
Oregon $18.40 $154.20 $39.57 7%
Pennsylvania $18.40 $149.60 $40.78 9%
Rhode Island $18.40 $127.60 $39.66 13%
South Carolina $18.40 $124.40 $41.44 6%
South Dakota $18.40 $124.20 $36.69 3%
Tennessee $18.40 $117.20 $42.16 16%
Texas $18.40 $163.00 $42.89 17%
Utah $18.40 $162.10 $44.17 9%
Vermont $18.40 $127.60 $39.66 13%
Virginia $18.40 $124.50 $43.90 19%
Washington $18.40 $154.20 $39.57 7%
West Virginia $18.40 $149.60 $40.78 9%
Wisconsin $18.40 $139.40 $44.35 16%
Wyoming $18.40 $124.20 $36.69 3%
TERRITORY
American Samoa $25.50 $25.50 $25.50 3%
Guam $28.70 $33.60 $28.71 34%
Northern Mariana Islands $19.10 $19.10 $19.10 63%
Puerto Rico $6.80 $70.20 $40.80 5%
Virgin Islands $38.00 $38.00 $38.00 -13%
NOTE: PDP is prescription drug plan. Analysis for 2016 includes 91 plans under CMS sanction and closed to new enrollees as of September 2015. Average monthly premium is weighted by 2015 enrollments for the region in which the state is located. Terminated plans are excluded in calculation of premium change.
SOURCE: Georgetown/Kaiser Family Foundation analysis of CMS 2015-2016 PDP crosswalk and landscape source files. 
Table A3: Number of PDPs Below Low-Income Subsidy Benchmark by State, 2006-2016
STATE/TERRITORY 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
U.S. Total 409 640 495 308 307 332 327 331 352 283 226
Alabama 9 17 15 12 9 11 12 13 11 12 8
Alaska 8 17 15 7 6 5 4 7 11 7 6
Arizona 6 10 7 2 8 9 10 10 11 12 10
Arkansas 13 23 18 12 15 17 15 15 12 6 4
California 10 14 9 6 7 5 6 6 9 6 6
Colorado 10 19 12 8 6 7 5 4 5 7 6
Connecticut 11 20 14 12 13 12 10 6 8 5 6
Delaware 15 21 18 11 11 12 13 13 13 10 9
District of Columbia 15 21 18 11 11 12 13 13 13 10 9
Florida 6 10 8 5 5 4 3 2 5 4 3
Georgia 14 21 18 11 8 14 12 13 9 8 5
Hawaii 8 18 10 5 7 6 10 10 4 9 2
Idaho 14 20 14 9 9 11 12 10 13 12 10
Illinois 15 23 19 12 10 10 10 10 14 10 9
Indiana 13 19 17 12 9 14 13 11 15 10 7
Iowa 14 20 16 9 8 10 9 8 10 5 5
Kansas 11 20 17 10 9 12 10 10 13 7 5
Kentucky 13 19 17 12 9 14 13 11 15 10 7
Louisiana 11 12 10 7 13 10 12 14 14 11 7
Maine 14 21 18 5 4 7 8 10 7 9 9
Maryland 15 21 18 11 11 12 13 13 13 10 9
Massachusetts 11 20 14 12 13 12 10 6 8 5 6
Michigan 14 26 17 11 9 12 12 10 13 10 8
Minnesota 14 20 16 9 8 10 9 8 10 5 5
Mississippi 12 21 15 13 10 14 12 13 13 9 6
Missouri 10 15 13 6 13 5 8 8 8 6 4
Montana 14 20 16 9 8 10 9 8 10 5 5
Nebraska 14 20 16 9 8 10 9 8 10 5 5
Nevada 7 9 5 1 5 4 2 2 4 4 4
New Hampshire 14 21 18 5 4 7 8 10 7 9 9
New Jersey 14 20 18 7 6 6 9 10 12 10 8
New Mexico 8 14 11 7 8 8 6 7 7 7 8
New York 15 16 15 9 11 11 12 12 8 8 8
North Carolina 13 21 17 11 8 11 9 8 10 8 7
North Dakota 14 20 16 9 8 10 9 8 10 5 5
Ohio 10 22 15 6 5 8 8 8 12 8 5
Oklahoma 12 20 13 8 10 10 9 11 12 10 6
Oregon 15 20 15 7 9 8 9 10 12 10 9
Pennsylvania 15 26 18 9 11 12 12 14 13 9 10
Rhode Island 11 20 14 12 13 12 10 6 8 5 6
South Carolina 16 26 20 15 13 15 12 14 8 7 4
South Dakota 14 20 16 9 8 10 9 8 10 5 5
Tennessee 9 17 15 12 9 11 12 13 11 12 8
Texas 16 19 15 14 11 12 13 12 11 10 8
Utah 14 20 14 9 9 11 12 10 13 12 10
Vermont 11 20 14 12 13 12 10 6 8 5 6
Virginia 16 21 17 13 11 10 10 10 13 9 7
Washington 15 20 15 7 9 8 9 10 12 10 9
West Virginia 15 26 18 9 11 12 12 14 13 9 10
Wisconsin 14 21 16 16 10 10 10 10 12 8 7
Wyoming 14 20 16 9 8 10 9 8 10 5 5
TERRITORY                      
American Samoa N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Guam N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Northern Mariana Islands N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Puerto Rico N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
Virgin Islands N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
NOTE: Benchmark plans are not designated (N/A) in the territories because low-income beneficiaries residing in the territories are not eligible for the low-income subsidy. Analysis for 2016 includes 91 plans under CMS sanction and closed to new enrollees as of September 2015.
SOURCE: Georgetown/Kaiser Family Foundation analysis of CMS 2006-2016 PDP landscape source files.

Appendix 2: Market Dynamics

  • Among the 31 new PDPs in the market, 21 are offered by sponsors totally new to the program: Magellan Rx America (20 PDPs in 20 regions) and QualChoice Advantage (1 PDP in Arkansas). The other new PDPs are additional offerings in a few regions by three national or near-national plan sponsors (EnvisionRxPlus, Symphonix Heath, and WellCare).
  • Four firms that offer PDPs on a national or near-national basis are eliminating one of the PDPs they offer in all or most regions. Aetna continued consolidating the PDPs it acquired from Coventry and now sponsors three PDPs instead of four, eliminating the Aetna Medicare Rx Premier PDP (42,000 enrollees across all regions). Two of its three offerings in each region are marketed under the First Health name. Cigna, after consolidating PDPs from its acquisition of HealthSpring, is eliminating one of its three PDPs (Cigna-HealthSpring Rx Secure-Max PDP with 22,000 enrollees). Express Scripts is eliminating the SmartD Rx Saver PDPs it acquired in 2014 (73,000 enrollees), leaving only two PDPs per region. Finally, TransAmerica eliminated its MedicareRx Choice PDPs (20,000 enrollees), leaving it with just a single PDP per region (and also dropped all PDPs in three regions, affecting another 2,000 enrollees).
  • Three plan sponsors, each operating a single PDP in just one region, left the program completely: Alliance Medicare RX PDP, Colorado Access Vista Medicare PDP, Health Alliance Medicare Prescription Plan – Basic PDP. Each PDP had about 1,000 enrollees.
  • Four other plan sponsors (EnvisionRxPlus, MedicareBlue Rx, SmartSaver Rx, and United American) made small adjustments to their offerings. The decision by Blue Cross Blue Shield plans in the upper Midwest region to drop their Value Plus PDP will affect about 100,000 enrollees, but the other changes have much smaller effects.

Appendix 3: Medicare Part D Standard Benefit Parameters, 2006-2016

Appendix 3: Medicare Part D Standard Benefit Parameters, 2006-2016

Appendix 3: Medicare Part D Standard Benefit Parameters, 2006-2016

Findings

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/KaiserFamFound

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.