December 15, 2021

HealthMetrix Research Identifies Part D Best Values for Commonly Prescribed
 Maintenance Drugs Among Selected $0 Premium 2022 Medicare Advantage+Part D Plans

      HealthMetrix Research recently completed the selection of $0 premium 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 forward-looking 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 network pharmacies. Part D estimated cost-sharing is based on member health status categories (excellent, fair, poor) with each category utilizing a basket of commonly prescribed brand and generic maintenance drugs.  A total of eight chronic conditions were identified for creating the basket of brand and generic drugs.

      HealthMetrix Research neither recommends nor endorses specific Medicare plans.   

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

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.   

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.