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How to read the Medicare Advantage, Cost Plans, and Demonstrations Landscape
The Landscape provides an overview of important information about each plan, including how much the plan costs and the kind of coverage it offers.
County: The county in which this plan is offered. First, find the county where you live and review the plans that are available there.
Organization Name: The name of the company offering the Medicare plan. Some companies may offer more than one Medicare plan.
Plan Name: The name of the Medicare plan. (The numbers following the name are a code that Medicare uses to identify the plan.)
Type of Medicare Health Plan: All plans listed are offered by private companies that contract with Medicare to give you coverage. Different types of plans have different rules for how you get your benefits and what you pay.
- Demo/Demonstration: A special project for a specific group in specific areas.
- Cost Plan: A type of HMO available in certain areas.
- Local HMO: A Health Maintenance Organization that is available in certain counties.
- Local PPO: A Preferred Provider Organization that is available in certain counties.
- MSA: A Medical Savings Account.
- PFFS: A Private Fee-for-Service Plan.
- Regional PPO: A Preferred Provider Organization that is available in a specific block of states.
Monthly Consolidated Premium (includes Part C + D): The total amount you pay the plan each month for your coverage in this plan.
Monthly Drug Premium: The amount of the Monthly Consolidated Premium that is for prescription drug coverage. This isn't an additional amount you pay. If If this column is blank, the plan doesn't include drug coverage.
Annual Drug Deductible: The amount you pay before the drug plan begins to pay. For 2009, this amount cannot be higher than $295. If this column is blank, the plan doesn't include drug coverage.
Drug Benefit Type: If this column is blank, the plan doesn't include drug coverage.
- Basic: In these plans, you typically pay a monthly premium and may have a yearly deductible. Once you meet the deductible, you and your plan share the costs of the prescriptions you need until your total drug costs reach a set limit. Then there is a coverage gap, where you are responsible for all of your costs.
- Enhanced: These plans may have higher monthly premiums than Basic plans, and offer added benefits, such as no deductible, lower copayments, or some coverage during the gap.
Type of Extra Coverage Offered in the Gap: All plans offer coverage until you hit a limit of $2,700 in total drug costs. And all plans offer coverage when your out-of-pocket costs exceed $4,350. Some plans offer coverage during the gap between $2,700 in total costs and $4,350 in out-of-pocket costs. This coverage may be for:
Generics
Generics & Preferred Brands
Generics & Brands
All Formulary Drugs
If this column is blank, the plan offers no drug coverage or no coverage during the gap.
Offers Variable Copayments: If there is a dot in this column, the amount you pay when you fill a prescription may be different for different levels of drugs. This amount may be a fixed copayment amount or a set percentage of the cost.
How to read the Stand-Alone Prescription Drug Plans Landscape
The Landscape provides an overview of important information about each plan, including how much the plan costs and the kind of coverage it offers.
Company Name: The name of the company offering the Medicare drug plan. Some companies may offer more than one Medicare drug plan.
Plan Name: The name of the Medicare drug plan. (The numbers following the name are a code that Medicare uses to identify the plan.)
Benefit Type:
Basic: In these plans, you typically pay a monthly premium and may have a yearly deductible. Once you meet the deductible, you and your plan share the costs of the prescriptions you need until your total drug costs reach a set limit. Then there is a coverage gap, where you are responsible for all of your costs.
Enhanced: These plans may have higher monthly premiums than Basic plans, and they may offer added benefits, such as no deductible, lower copayments, or some coverage during the gap.
$0 Premium with Full Low-Income Subsidy: If you get full Extra Help from Medicare paying your prescription drug coverage costs, you won't pay any premium for plans with a dot in this column.
Offers Variable Copayments: If there is a dot in this column, the amount you pay when you fill a prescription may be different for different levels of drugs. This amount may be a fixed copayment amount or a set percentage of the cost.
Monthly Drug Premium: The total amount you pay the plan each month for your prescription drug coverage.
Annual Drug Deductible: The amount you pay before the drug plan begins to pay. For 2009, this amount cannot be higher than $295.
Type of Extra Coverage Offered in the Gap: All plans offer coverage until you hit a limit of $2,700 in total drug costs. And all plans offer coverage when your out-of-pocket costs exceed $4,350. Some plans offer coverage during the gap between $2,700 in total costs and $4,350 in out-of-pocket costs. This coverage may be for:
Generics
Generics & Preferred Brands
All Formulary Drugs
If this column is blank, that plan offers no coverage during the gap.
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