December 15, 2021

HealthMetrix Research Identifies Part D Best Values for Commonly Prescribed
 Maintenance Drugs Among Selected 2022 Medicare Advantage+Part D Plans

      HealthMetrix Research recently completed the selection of Medicare Advantage+Part D (MA+Part D) plans identified as best values for commonly prescribed maintenance drugs in 47 states, plus Washington DC and Puerto Rico.  The selections recognize plans whose Part D benefits offer favorable design structure for their members, especially those with chronic health conditions.  Key benefit design elements include:  A) brand and generic formulary selection; B) drug tier categorization; C) deductibles, copays, 'donut hole' thresholds.  In addition, all of the selected MA+Part D plans achieved at least CMS 4-Star ratings for 2022 drug plan quality and satisfaction.

      HealthMetrix Research president This email address is being protected from spambots. You need JavaScript enabled to view it. notes: "This represents critical findings that informed Medicare beneficiaries should find useful in evaluating their MA+Part D plan options, especially in the event their health status deteriorates resulting in increased reliance on maintenance drugs to treat their conditions.  Unfortunately, the Medicare.gov Medicare Plan Finder (MPF) is of limited value and lacks a forecasting tool to compare projected cost-sharing impact for members as their health status changes while enrolled in their MA+Part D plans."

      The principal selection screen was the HealthMetrix Research 2022 CostShare Report that carves out estimated annual cost-sharing for selected Part D maintenance drugs commonly prescribed and filled by 90-day mail order pharmacy providers. Part D estimated cost-sharing is based on three member health status categories (excellent, fair, poor) with each category utilizing a basket of selected brand and generic maintenance drugs.

      HealthMetrix Research neither recommends nor endorses specific Medicare plans.   

                                                                                                       * * * * *

Part D Best Values for Commonly Prescribed Maintenance Drugs
by State Among Selected 2022 Medicare Advantage+Part D Plans


 

 

AL

AZ

 

IA

KS

KY

 

NH

NJ

NM

 

SD

TN

 
 

AR

CA

 

 

LA

ME

MD

 

NY

 

TX

UT

VA

 

 

 

CO

 

CT

DC

DE

 

MA

MI

MN

MS

 

NC

ND

See Honorable Mention Note 
Below

OH

OK

 

WA

WV


WI

 
 

FL

 

MO

NE

NV 

 

 OR

 

PR

PA

     
 

HI

ID

IL

See Honorable Mention Note Below

IN

See Honorable Mention Note Below

     

RI

See Honorable Mention Note
Below

SC

 

 

 

 


Honorable Mention

The following MA+Part D plans demonstrate favorable brand and generic formulary selection, drug tier design and cost-sharing for members with chronic conditions, however, they are too new to receive CMS star ratings.   

 

 

IL

    

IN 

    

    

 

ND

    

RI

    

VT

    

 

 

 

  


Sources

HealthMetrix Research 2022 CostShare Reports, October 2021.

CMS/Medicare.gov 2022 Medicare Plan Finder, October 2021.

Medicare Part D Drugs-2019, CMS/Office of Enterprise Data & Analytics (OEDA), December 2020.