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Effective: January 1, 2013 |
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04.40.20.05ar9 - Medicare Part D Benchmark Plans (Archive) |
Archived: December 1, 2013 |
This section lists health plans providing Medicare Part D that are considered Medicare Part D Benchmark Plans for the applicable year.
l Clients enrolled in a benchmark plan may or may not be receiving Extra Help. See Medicare Part D for more information on the Extra Help subsidy.
l Determine if clients enrolled in a benchmark plan are receiving Extra Help.
l Do not use the premium amount or cost-sharing amounts paid by Extra Help as a medical expense or Medicare premium deduction for a spenddown or LTC income calculation. See MA and Medicare Part D for more information.
l See Medicare Part D Cost-Sharing Amounts for information on the benchmark premium amount and other Part D cost-sharing amounts.
2013 Medicare Part D Benchmark Plans.
2012 Medicare Part D Benchmark Plans not Benchmark plans in 2013.
2012 Medicare Part D Benchmark Plans.
2013 Medicare Part D Stand Alone Benchmark Plans
The following are the stand alone Medicare Part D benchmark plans for 2013:
l AARP MedicareRx Saver Plus.
l Aetna Medicare CVS Pharmacy Prescription Drug Plan.
l Cigna Medicare RX Plan One.
l EnvisionRx Plus Silver.
l Humana Walmart - Preferred Rx Plan.
l Silverscript CVS Caremark Value.
l SmartD Rx Saver.
l Windsor Rx.
See the "2013 Amounts in Excess of Medicare Part D Benchmark to Apply as Medical Expense" document for more information on Medicare Part D benchmark plans in which a person is enrolled in conjunction with a Medicare Part C (Medicare Advantage) plan.
2012 Medicare Part D Benchmark Plans not Benchmark Plans in 2013
The following 2012 benchmark plan will not be a benchmark plan in 2013:
l First Health Part D Premier
2012 Medicare Part D Stand Alone Benchmark Plans
The following are the stand alone Medicare Part D benchmark plans for 2012:
l Aetna Medicare CVS Pharmacy PDP.
l Cigna Medicare RX Plan One.
l EnvisionRx Plus Silver.
l First Health Part D Premier.
l Humana Walmart - Preferred Rx Plan.
l Medco Medicare Prescription Plan - Value.
l Silverscript CVS Caremark Value.
l Sterling Windsor Rx.
l Universal American Community CCRx Basic.
See the "2012 Amounts in Excess of Medicare Part D Benchmark to Apply as Medical Expense" document for more information on Medicare Part D benchmark plans in which a person is enrolled in conjunction with a Medicare Part C (Medicare Advantage) plan.
Some people enrolled in these plans may be required to pay a premium if they stay in the non-benchmark plan. The rules for which plans meet benchmark qualifications are established by the Centers for Medicare and Medicaid Services (CMS). One factor is whether the Part D plan's premium is equal to or within a few dollars of the regional Extra Help subsidy amount.
Full-benefit dual eligibles who were randomly assigned and enrolled in a benchmark plan by CMS may be reassigned to a new randomly-chosen benchmark plan by CMS, if their plan is no longer a benchmark plan.