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