Comparing Total Annual Drug Costs Among Several Managed Care Plans

Premiums for Medicare Advantage drug plans, shown in parentheses below, range from zero to $85 a month. Premiums aside, total out-of-pocket costs can vary widely, based in part on whether a person is basically healthy, needs only episodic drug treatment or has chronic medication needs.


VIRGINIA Healthy Episodic Chronic
AETNA HEALTH Golden Medicare Standard ($35) $716 $2,069 $5,161
AETNA HEALTH Golden Medicare Premier ($85) $1,236 $1,839 $3,619
HUMANA Gold Choice PFFS ($0) $380 $1,690 $5,153
KAISER PERMANENTE Medicare Plus ($49) $943 $2,153 $5,260
KAISER PERMANENTE Medicare Plus ($79) $1,233 $2,098 $4,080
AVERAGE $902 $1,970 $4,655

MARYLAND AND D.C Healthy Episodic Chronic
AETNA HEALTH Golden Medicare Standard ($35) $716 $2,069 $5,161
AETNA HEALTH Golden Medicare Premier ($85) $1,236 $1,839 $3,619
ELDER HEALTH HMO Elder Health Plus ($35) $964 $1,761 $3,852
ELDER HEALTH HMO Elder Health Choice ($0) $654 $1,476 $3,567
KAISER PERMANENTE Medicare Plus ($49) $943 $2,153 $5,260
KAISER PERMANENTE Medicare Plus ($79) $1,233 $2,098 $4,080
AVERAGE $958 $1,899 $4,257

Calculations do not include the 2006 Medicare Part B premium of $88.50 per month.


How Much Might You Pay? A Sampling of Drug Plans

Prescription Drug Plan Monthly Premium Deductible Co-payments and Coinsurance Coverage in the Gap* Total Annual Out-of-Pocket Drug Costs
Humana Standard $6.44 $250 25% on all tiers No $1,122.47
Coventry AdvantraRx Value $21.21 $0 $10-Tier 1
$42-Tier 2
No $2,206.38
United Healthcare/AARP MedicareRx Plan $28.61 $0 $5-Tier 1
$28-Tier 2
$55-Tier 3
25%-Specialty
No $1,568.34
PacifiCare Life and Health Insurance Co. $38.16 $0 $7.50-Tier 1
$22-Tier 2
$52.60-Tier 3 33%-Specialty
Yes, generic only $2,631.72
Aetna Medicare Rx Premier $58.36 $0 $2-Tier 1
$20-Tier 2
$40-Tier 3
Yes, generic only $1,842.30
Prescription Pathway Platinum Plan $68.91 $0 $6-Tier 1
$24-Tier 2
$40-Tier 3
25%-Specialty
No $2,109.80

* The coverage gap, or "doughnut hole," starts when total spending for drugs reaches $2,250 and ends when spending hits $5,100. Catastrophic coverage then begins.
** These costs include premiums, deductibles and payments for common doses of four drugs (atenolol, Fosamax, Lexapro and Lipitor), purchased at a CVS pharmacy in Maryland. Prices may vary in the District and Virginia, and at other retailers.

SOURCE: HealthMetrix Research, Medicare.gov | GRAPHIC: The Washington Post - November 15, 2005


© 2005 The Washington Post Company