November 4, 2024
HealthMetrix Research Identifies Best Part D Values for Commonly Prescribed
Maintenance Drugs Among Selected 2025 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. All of the selected MA+Part D plans fell within the new $2,000 annual cap on Part D drug costs. In addition, all of the selected MA+Part D plans were selected for the 2025 Senior Choice Gold Award recognizing "Excellence in 2025 Medicare Benefits Value & Performance."
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. The selected MA+Part D plans combine depth of their formularies with favorable benefit design to deliver member peace of mind during 2025."
The principal selection screen was the HealthMetrix Research 2025 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 12 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 Among Selected
2025 Medicare Advantage+Part D Plans by Annual Estimated Out-of-Pocket Cost (OOPC)
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<$1,000 OOPC
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$1,500 - $1,999 OOPC
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Sources
HealthMetrix Research 2025 CostShare Reports, October 2024.
CMS/Medicare.gov 2025 Medicare Plan Finder, October 2024.
Medicare Part D Drugs-2022, CMS/Office of Enterprise Data & Analytics (OEDA), December 2023.
