Medicare Part D: A First Look at Prescription Drug Plans in 2020
| Table 1: Medicare Part D Stand-alone Prescription Drug Plans, Benchmark Plans, and Monthly Premiums, 2019 and 2020 | ||||||
| Number of PDPs | Number of Benchmark PDPs | Weighted Average PDP Monthly Premium | ||||
| State/territory | 2019 | 2020 | 2019 | 2020 | 2019 | 2020 |
| U.S. Total | 901 | 948 | 215 | 244 | $39.13 | $42.05 |
| Alabama | 29 | 30 | 6 | 7 | $41.65 | $44.55 |
| Alaska | 22 | 24 | 7 | 7 | $36.94 | $38.93 |
| Arizona | 28 | 31 | 10 | 12 | $38.29 | $42.77 |
| Arkansas | 26 | 27 | 4 | 6 | $34.30 | $37.49 |
| California | 30 | 32 | 7 | 8 | $43.50 | $43.20 |
| Colorado | 26 | 26 | 7 | 7 | $38.38 | $42.36 |
| Connecticut | 26 | 25 | 7 | 7 | $42.27 | $44.78 |
| Delaware | 25 | 27 | 9 | 10 | $39.33 | $43.32 |
| District of Columbia | 25 | 27 | 9 | 10 | $35.09 | $36.37 |
| Florida | 27 | 27 | 2 | 4 | $42.45 | $45.72 |
| Georgia | 26 | 28 | 4 | 6 | $36.77 | $38.59 |
| Hawaii | 24 | 25 | 4 | 5 | $32.15 | $33.97 |
| Idaho | 26 | 28 | 8 | 8 | $37.92 | $42.37 |
| Illinois | 27 | 28 | 7 | 8 | $39.01 | $42.30 |
| Indiana | 26 | 28 | 7 | 7 | $37.17 | $40.33 |
| Iowa | 28 | 29 | 6 | 8 | $34.36 | $39.49 |
| Kansas | 26 | 28 | 4 | 6 | $38.33 | $39.51 |
| Kentucky | 26 | 28 | 7 | 7 | $37.32 | $39.33 |
| Louisiana | 26 | 26 | 8 | 9 | $37.26 | $39.50 |
| Maine | 26 | 26 | 7 | 6 | $39.46 | $40.12 |
| Maryland | 25 | 27 | 9 | 10 | $37.75 | $40.96 |
| Massachusetts | 26 | 25 | 7 | 7 | $39.95 | $42.37 |
| Michigan | 29 | 30 | 9 | 9 | $37.18 | $39.93 |
| Minnesota | 28 | 29 | 6 | 8 | $34.98 | $39.75 |
| Mississippi | 24 | 25 | 5 | 7 | $34.46 | $36.05 |
| Missouri | 26 | 28 | 4 | 5 | $38.30 | $41.33 |
| Montana | 28 | 29 | 6 | 8 | $35.73 | $40.50 |
| Nebraska | 28 | 29 | 6 | 8 | $34.08 | $38.76 |
| Nevada | 26 | 28 | 3 | 5 | $36.63 | $40.38 |
| New Hampshire | 26 | 26 | 7 | 6 | $38.56 | $40.76 |
| New Jersey | 26 | 28 | 6 | 8 | $43.82 | $49.10 |
| New Mexico | 27 | 26 | 7 | 7 | $33.15 | $36.15 |
| New York | 23 | 27 | 8 | 9 | $44.13 | $47.84 |
| North Carolina | 28 | 28 | 7 | 9 | $38.97 | $41.82 |
| North Dakota | 28 | 29 | 6 | 8 | $34.37 | $37.84 |
| Ohio | 26 | 28 | 7 | 2 | $37.68 | $41.43 |
| Oklahoma | 28 | 29 | 7 | 8 | $40.43 | $41.58 |
| Oregon | 26 | 28 | 7 | 8 | $35.64 | $38.80 |
| Pennsylvania | 30 | 31 | 9 | 10 | $38.94 | $42.23 |
| Rhode Island | 26 | 25 | 7 | 7 | $39.21 | $42.57 |
| South Carolina | 26 | 28 | 3 | 5 | $36.63 | $42.85 |
| South Dakota | 28 | 29 | 6 | 8 | $33.70 | $39.65 |
| Tennessee | 29 | 30 | 6 | 7 | $38.36 | $41.83 |
| Texas | 27 | 30 | 5 | 5 | $36.34 | $39.68 |
| Utah | 26 | 28 | 8 | 8 | $39.91 | $44.54 |
| Vermont | 26 | 25 | 7 | 7 | $38.58 | $42.25 |
| Virginia | 27 | 29 | 6 | 7 | $40.00 | $40.36 |
| Washington | 26 | 28 | 7 | 8 | $37.36 | $40.52 |
| West Virginia | 30 | 31 | 9 | 10 | $40.04 | $42.91 |
| Wisconsin | 28 | 30 | 8 | 9 | $40.31 | $45.53 |
| Wyoming | 28 | 29 | 6 | 8 | $38.95 | $43.21 |
| Puerto Rico | 6 | 6 | — | — | $42.40 | $52.03 |
| American Samoa | 1 | 1 | — | — | $34.70 | $43.40 |
| Guam | 2 | 2 | — | — | $39.88 | $45.38 |
| Northern Mariana Islands | 1 | 1 | — | — | $37.20 | $30.20 |
| U.S. Virgin Islands | 1 | 1 | — | — | $42.60 | $47.40 |
| NOTES: 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 2019 enrollment. 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 2020). 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 2019-2020 Part D plan files. |
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Table 2: National Medicare Part D Stand-alone Prescription Drug Plans in 2020 |
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|
PDP name |
Type of plan |
Benchmark PDP |
Enrollment1 |
Weighted average monthly premium2 | ||||
|
Number (in millions) |
% of total |
Top 10 in 2019 |
2019 |
2020 |
% change |
|||
|
ALL PDPs |
20.49 |
100.00% |
$39 |
$42 |
7% |
|||
|
AARP MedicareRx Preferred |
Enhanced3 |
No |
2.21 |
10.8 |
2 |
$75 |
$79 |
6% |
|
AARP MedicareRx Saver Plus |
Basic |
Yes |
1.25 |
6.1 |
5 |
$34 |
$32 | -4% |
|
AARP MedicareRx Walgreens |
Enhanced |
No |
0.74 |
3.6 |
8 |
$28 |
$34 | 23% |
|
Cigna-HealthSpring Rx Secure |
Basic |
Yes4 |
0.51 |
2.5 |
$32 | $30 | -5% | |
|
Cigna-HealthSpring Rx Secure-Essential |
Enhanced |
No |
0.07 |
0.3 |
$22 | $22 | 1% | |
|
Cigna-HealthSpring Rx Secure-Extra |
Enhanced |
No |
0.15 |
0.7 |
$57 | $57 | <1% | |
|
EnvisionRxPlus |
Basic4 |
Yes4 |
0.54 |
2.6 |
$17 | $16 | -3% | |
|
Express Scripts Medicare – Choice |
Enhanced |
No |
0.05 |
0.2 |
$93 | $83 | -11% | |
|
Express Scripts Medicare – Saver |
Enhanced |
No |
0.21 |
1.0 |
$24 | $25 | 1% | |
|
Express Scripts Medicare – Value |
Basic |
Yes5 |
0.45 |
2.2 |
$35 | $36 | 2% | |
|
Humana Basic Rx Plan |
Basic |
Yes4 |
1.57 |
7.7 |
$31 | |||
|
Humana Preferred Rx Plan |
Crosswalked to Humana Basic Rx Plan |
4 |
$31 | -1% | ||||
|
Humana Premier Rx Plan |
Enhanced |
No |
2.62 |
12.8 |
$57 | |||
|
Humana Walmart Rx Plan |
Crosswalked to Humana Premier Rx Plan |
3 |
$28 | 107% | ||||
|
Humana Enhanced |
Crosswalked to Humana Premier Rx Plan |
9 |
$76 | -25% | ||||
|
Humana Walmart Value Rx Plan |
Enhanced |
No |
New in 2020 |
$136 | ||||
|
SilverScript Choice |
Basic |
Yes4 |
4.40 |
21.5 |
1 |
$31 | $29 | -7% |
|
WellCare Classic |
Basic |
Yes4 |
0.89 |
4.3 |
7 |
$32 | $29 | -9% |
|
WellCare Medicare Rx Saver |
Basic |
Yes4 |
1.17 |
5.7 |
$31 | |||
|
Aetna Medicare Rx Saver |
Crosswalked to WellCare Medicare Rx Saver |
6 |
$29 | 6% | ||||
|
WellCare Medicare Rx Select |
Enhanced |
No |
0.70 |
3.4 |
$21 | |||
|
Aetna Medicare Rx Select |
Crosswalked to WellCare Medicare Rx Select |
10 |
$17 | 23% | ||||
|
WellCare Medicare Rx Value Plus |
Enhanced |
No |
0.52 |
2.5% |
$72 | |||
|
Aetna Medicare Rx Value Plus |
Crosswalked to WellCare Medicare Rx Value Plus |
$60 | 20% | |||||
|
WellCare Extra |
Crosswalked to WellCare Medicare Rx Value Plus |
$71 | 1% | |||||
|
WellCare Value Script |
Enhanced |
No |
0.74 |
3.6% |
$15 | $17 | 14% | |
|
WellCare Wellness Rx |
Enhanced |
No |
New in 2020 |
$146 | ||||
| NOTES: PDP is prescription drug plan. Analysis excludes enrollees in employer group plans. 1Enrollment as of September 2019, includes enrollees with and without low-income subsidies; for enrollees being crosswalked into new plan for 2020, enrollment is shown in the crosswalked plan. Top 10 in 2019 based on March 2019 enrollment. 2Weighted by September 2019 enrollment. 3In all regions except territories. 4In most regions. 5In some regions. 6Unweighted median because PDP is new for 2020. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2019-2020 Part D plan files. |
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| Table 3: Benefit Designs and Deductibles in Medicare Part D Stand-alone Prescription Drugs Plans, 2019 and 2020 | ||
| 2019 | 2020 | |
| Share of PDPs offering (number of plans1) | ||
| Basic benefits | 39% (348) | 40% (382) |
| Enhanced benefits | 61% (553) | 60% (566) |
| Standard deductible | 52% (468) | 69% (654) |
| Lower deductible | 19% (170) | 17% (161) |
| No deductible | 29% (263) | 14% (133) |
| Weighted average monthly PDP premium2 | ||
| Basic benefits | $31.97 | $30.90 |
| Enhanced benefits | $48.76 | $57.03 |
| Standard deductible | $31.54 | $36.03 |
| Lower deductible | $33.93 | $31.78 |
| No deductible | $75.37 | $80.60 |
| NOTES: PDP is prescription drug plan. 1Excludes plans in the territories. 2Weighted by September 2019 enrollment. SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2019-2020 Part D plan files. |
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| Table 4: Median Cost Sharing for National Medicare Part D Stand-alone Prescription Drug Plans, 2019 and 2020 | ||||||||||
| Plan name | Formulary tier cost-sharing amounts | |||||||||
| Preferred generics ($) | Generics ($) | Preferred brands1 | Non-preferred drugs (%) | Specialty tier drugs (%) | ||||||
| 2019 | 2020 | 2019 | 2020 | 2019 | 2020 | 2019 | 2020 | 2019 | 2020 | |
| ALL PDPs | $1 | $0 | $5 | $3 | $40/ 20% | $42/ 25% | 40% | 38% | 25% | 25% |
| AARP MedicareRx Preferred | 5 | 5 | 10 | 10 | $40 | $45 | 40% | 40% | 33 | 33 |
| AARP MedicareRx Saver Plus | 1 | 1 | 6 | 6 | $25 | $26 | 33 | 35 | 25 | 25 |
| AARP MedicareRx Walgreens | 0 | 0 | 5 | 5 | $30 | $40 | 32 | 32 | 25 | 25 |
| Cigna-HealthSpring Rx Secure-Essential | 1 | 0 | 3 | 2 | 20% | 18% | 49 | 43 | 25 | 25 |
| Cigna-HealthSpring Rx Secure-Extra | 4 | 4 | 10 | 10 | $42 | $42 | 50 | 50 | 31 | 31 |
| Cigna-HealthSpring Rx Secure | 1 | 1 | 3 | 2 | $30 | $30 | 36 | 36 | 25 | 25 |
| EnvisionRxPlus | 1 | 1 | 6 | 7 | $34 | $352 | 36 | 33 | 25 | 25 |
| Express Scripts Medicare Choice | 2 | 2 | 7 | 7 | $42 | $42 | 48 | 48 | 26 | 28 |
| Express Scripts Medicare Saver | 1 | 1 | 4 | 4 | 18% | $30 | 32 | 47 | 25 | 25 |
| Express Scripts Medicare Value | 1 | 1 | 3 | 3 | $25 | $25 | 39 | 35 | 25 | 25 |
| Humana Basic Rx Plan | 0 | 0 | 1 | 1 | 25% | 25% | 37 | 38 | 25 | 25 |
| Humana Premier Rx Plan | 1 | 1 | 4 | 4 | $47 | $42 | 35 | 44 | 25 | 25 |
| Humana Walmart Value Rx Plan | n/a | 1 | n/a | 4 | n/a | $47 | n/a | 35 | n/a | 25 |
| SilverScript Choice | 3 | 0 | 13 | 1 | $42 | $47 | 45 | 38 | 33 | 27 |
| WellCare Classic | 0 | 0 | 2 | 2 | $37 | $32 | 41 | 34 | 25 | 25 |
| WellCare Medicare Rx Saver | 1 | 0 | 2 | 2 | $30 | $28 | 35 | 38 | 27 | 25 |
| WellCare Medicare Rx Select | 0 | 0 | 2 | 3 | $47 | $47 | 40 | 42 | 25 | 25 |
| WellCare Medicare Rx Value Plus | 1 | 1 | 2 | 4 | $47 | $47 | 47 | 47 | 33 | 33 |
| WellCare Value Script | 0 | 0 | 6 | 7 | $40 | $43 | 46 | 47 | 25 | 25 |
| WellCare Wellness Value Rx | n/a | 0 | n/a | 5 | n/a | $40 | n/a | 46 | n/a | 25 |
| NOTES: PDP is prescription drug plan. Estimates are weighted medians for those plans that vary cost sharing by region (weighted by September 2019 enrollment). n/a is not applicable because plan is new for 2020. 1Approximately 91% of September 2019 enrollees are in plans with a preferred brand copay and 9% are in plans with a preferred brand coinsurance. 211% of EnvisionRxPlus enrollees will pay coinsurance of 15% for the preferred brand tier.
SOURCE: KFF analysis of Centers for Medicare & Medicaid Services 2019-2020 Part D plan files. |
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