Also see:  Anthem, Blue Cross Blue Shield Affiliates, Humana Head List of Most Member Favorable Part D Values for Commonly Prescribed 
                       Maintenance Drugs Among Selected $0 Premium 2023 Medicare Advantage Plans-11/2/2022 
   Also see:  Why Medicare Advantage Plans Should Super-Size Baseline Prevention Screenings-4/1/2022
   Also see:  Addressing Inflation Essential for Successful OEP, Age-in, Member Retention, AEP Messaging Strategies-2/27/2022 
   Also see:  Humana, Anthem, Bright HealthCare Head List of Most Favorable Part D Values-2/1/2022
   
Also see:  2023 Medicare Plan Finder Initiative -- Build, Back, Smarter-1/3/2022

November 1, 2022

HealthMetrix Research Identifies Best Part D Values for Commonly Prescribed
 Maintenance Drugs Among Selected 2023 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 3.5-Star ratings for 2023 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 2023 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 10 chronic conditions were identified for creating the basket of brand and generic drugs.

      HealthMetrix Research neither recommends nor endorses specific Medicare plans.   

                                                                                                       * * * * *

Part D Best Values for Commonly Prescribed Maintenance Drugs
by State Among Selected 2023 Medicare Advantage+Part D Plans


 

 

AL

AZ

AR

CA



CO

DC

DE

FL

GA

HI

ID

IL

 

IA     

KY

LA

ME

MD

MA
     

MI

MN         

MS

MO  

NE

NV 


NH  

NJ

NM

 

NY

 

NC

OH

OK

OR

PR 

PA




RI

SC 
     

SD 

TN

    

 

TX

UT 

VA 

VT
        

WA

WV

WI

 

 


Honorable Mention

The following Medicare Advantage+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.   

 

 

CT 

IN 

        

 

KS     

    

 

    

 

 

 

  


Sources

HealthMetrix Research 2023 CostShare Reports, October 2022.

CMS/Medicare.gov 2023 Medicare Plan Finder, October 2022.

Medicare Part D Drugs-2020, CMS/Office of Enterprise Data & Analytics (OEDA), December 2021.