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2017 Medicare Part D and Medicare Advantage Plans - NYS

Views: 4151
Posted: 23 Sep, 2016
by Valerie Bogart (New York Legal Assistance Group)
Updated: 23 Sep, 2016
by Valerie Bogart (New York Legal Assistance Group)

The annual coordinated election period ("open enrollment") for Medicare Part D and Medicare Advantage plans runs from October 15 through December 7, 2016.  CMS has released the 2017 landscape of Part D and Medicare Advantage plans.  Here are the lists of plans for New York State:

  1.    Standalone Part D (PDP) - 19 Plans, of which 2 CIGNA plans are currently sanctioned with enrollment and marketing suspended since Jan. 2016

  2.    Medicare Advantage Plans

  3.    Special Needs Plans (SNPs)  ( will be posted soon)

  4.    Dual Plans (full capitation -cover Medicare & Medicaid services - FIDA and Medicaid Advantage Plans

LIST OF EIGHT BENCHMARK PLANS - FREE PREMIUM FOR PEOPLE WITH FULL "EXTRA HELP" (Low Income Subsidy) .  All of the benchmark plans from 2016 will be benchmark in 2017, except that one plan is sanctioned - Cigna Medicare Rx:

  • The 2017 benchmark amount in New York State is $40.99 (highest in the USA). 

  • EIGHT of the standalone PDPs in NYS  are free to people with FULL Extra Help in NYS in 2017 (no monthly premium).  BUT ONE of the 8 PLANs - CIGNA MEDICARE RX - IS SANCTIONED so no enrollment permitted.  Benchmark plans are "Basic" Part D plans with premiums below the benchmark amount, to which people with the Low Income Subsidy are randomly assigned if they do not pick a plan.   "Enhanced" Part D plans cannot be "benchmark" plans even if their premium is below the benchmark amount.

  • People with Extra Help will be assigned to one of these SEVEN Plans  if they don't pick their own plan (it will be EIGHT Plans when sanction is lifted from CIGNA MEDICARE RX.  They can pick a plan that is not one of the 8 benchmark plans, but they'll be charged the difference between the benchmark premium of $40.99 and the plan's full premium listed on the chart.

  • All plans that were benchmark in 2016 will still be benchmark in 2017:

  1. Aetna Medicare Rx Saver (PDP) 
  2. Cigna-Healthspring Rx Secure (PDP) (UNDER SANCTION - no enrollment since 1/2016)
  3. Express Scripts Medicare - Value (PDP)
  4. Humana Preferred Rx Plan (PDP) 
  5. SilverScript Choice (PDP) (formerly called "Basic")
  6. WellCare Classic (PDP)
  7. EnvisionRxPlus Silver (PDP) 
  8. Magellan Rx Medicare Basic (PDP)

The lists posted here are extracted from nationwide charts on the CMS website at  http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/.    Sanctioned plans are also available at that link. 

Reminder:  EPIC does not provide coverage during the Part D deductible phase.   EPIC members without Extra Help will want to try to find Part D plans with no deductible, if possible.   In 2017, EPIC can pay up to $40.99/month for members getting EPIC Part D premium assistance, and will credit EPIC deductible members $40.99/ month ($492/year) toward their annual EPIC deductible.  

Attached files
file Benchmark Plans 2016-2017 Comparison.pdf (151 kb)
file 2017LandscapeSource NYS PDP 09072016.xls (29 kb)
file 2017 Medicare Advantage Plans NYS .xlsx (115 kb)

Also read
document Medicare Part D - Overview (2016)
document The Medicare planfinder tool: get (almost) all the info you'll ever need to help you pick the best possible prescription drug plan

Also listed in
folder Medicare Part D

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2018 Medicare Part D and Medicare Advantage Plans - NYS     Medicare Part D - Overview (2016)


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