Medicare drug benefits in Indiana help pay for your prescriptions. Qualified Medicare recipients can select a plan from several insurance companies. Coverage is optional, and rates will vary, depending upon the carrier and benefits. A late enrollment penalty may be imposed if you wait too long to join a plan and did not have other creditable coverage. The penalty will be applicable as long as Medicare benefits are being paid.
Prescription drug benefits are often included in Medicare Advantage plans (Part C), but stand-alone Part D coverage is commonly purchased with a Supplement contract. Requirements include US citizenship or residing lawfully in the country. When signing up for coverage, an enrollment form will need to be completed, and your Part A and/or Part B starting dates will be needed. You can enroll in a separate drug plan (while retaining current medical benefits), if you are in a cost plan, MSA, private fee-for-service plan, and some employer-sponsored Medicare health plans. Note: Supplemental discount plans, including GoodRx, may be used with Part D plans.
Each plan must adhere to standardized rules that are administered by Medicare.gov. Coverage rules include medication safety checks, step therapy, quantity limits, prior authorization, Part D vaccine coverage, and drugs received for outpatient situations.
The initial 2024 deductible increases to $545 from $505. The initial coverage limit (ICL) increases to $5,030 from $4,660. The out-of-pocket threshold (trOOP) increases to $8,000 from $7,400. The 2024 coverage gap (donut hole) starts once you reach the policy ICL and ends when $8,000 of out-of-pocket expenses are reached. A donut hole discount of 75% is given to enrollees towards the purchase of brand-name drugs. The total covered Part D drug out-of-pocket spending to exit the coverage gap is $11,477.39 (LIS). The total estimated Part D drug out-of-pocket spending to exit the coverage gap is $12,447.11 (non-LIS).
Indiana Part D Prescription Drug Plan General Information (CMS Region 15)
Twenty-one plans are offered, compared to 24 for 2023, and 23 for 2022. There are 13 Enhanced (EA) options, and 8 Basic (AE, DS, and BA) options. Four $0 deductible plans are offered (Anthem MediBlue Rx Plus, Wellcare Medicare Rx Value Plus, Humana Premier Rx, and AARP Medicare Rx Preferred from UHC. The least expensive rate for a $0 deductible plan is $78.90. A total of five plans offer premiums less than $25.
The most expensive plan is Humana Premier Rx at a monthly cost of $109.40. The average and average weighted PDP monthly premiums are $56.73 and $44.35. Five plans include gap coverage for the Donut Hole. The least expensive PDP plan with gap benefits costs $39.10 per month. The LIS Benchmark monthly premium is $42.34 (three plans qualify). Three Indiana PDP plans had premium decreases, while 18 plans had premium increases.
All Available Plans are Listed Below:
AARP Medicare Rx Preferred from UHC – $93.20 monthly premium with $0 deductible and 3,622 available formulary drugs. Available drugs are 157 (Tier 1), 723 (Tier 2), 1,013 (Tier 3), 1,064 (Tier 4), and 683 (Tier 5). 30,586 members are enrolled in Indiana, and 1,375,327 members are enrolled countrywide. The Plan Summary Star Rating is 3.5. 30-day preferred pharmacy drug copays are $7 (preferred generic), $12 (generic), $47 (preferred brand), and 40% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $0 (generic), $126 (preferred brand), and 40% (non-preferred). No additional gap coverage.
AARP Medicare Rx Basic from UHC – $29.30 monthly premium with $505 deductible and 3,009 available formulary drugs. Available drugs are 54 (Tier 1), 451 (Tier 2), 799 (Tier 3), 1,113 (Tier 4), and 608 (Tier 5). 18,330 members are enrolled in Indiana, and 766,415 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $2 (preferred generic), $8 (generic), 17% (preferred brand), and 42% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $6 (preferred generic), $24 (generic), 17% (preferred brand), and 42% (non-preferred). No additional gap coverage.
AARP Medicare Rx Walgreens – $54.20 monthly premium with $410 deductible and 3,253 available formulary drugs. Available drugs are 245 (Tier 1), 488 (Tier 2), 788 (Tier 3), 1,119 (Tier 4), and 630 (Tier 5). 15,155 members are enrolled in Indiana, and 856,056 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $2 (preferred generic), $8 (generic), $40 (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $6 (preferred generic), $124 (generic), $120 (preferred brand), and 50% (non-preferred). Some additional gap coverage.
Anthem MediBlue Rx Plus – $94.70 monthly premium with $0 deductible and 3,199 available formulary drugs. Available drugs are 142 (Tier 1), 469 (Tier 2), 1,062 (Tier 3), 1,073 (Tier 4), and 464 (Tier 5). 10,553 members are enrolled in Indiana, and 88,432 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $4 (generic), $47 (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $3 (preferred generic), $12 (generic), $141 (preferred brand), and 50% (non-preferred). No additional gap coverage.
Anthem MediBlue Rx Standard – $54.70 monthly premium with $545 deductible and 2,919 available formulary drugs. Available drugs are 59 (Tier 1), 384 (Tier 2), 1,093 (Tier 3), 939 (Tier 4), and 453 (Tier 5). 3,645 members are enrolled in Indiana, and 36,485 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $3 (generic), 20% (preferred brand), and 39% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $3 (preferred generic), $9 (generic), 20% (preferred brand), and 39% (non-preferred). No additional gap coverage.
Cigna Extra Rx – $61.70 monthly premium with $100 deductible and 3,342 available formulary drugs. Available drugs are 175 (Tier 1), 584 (Tier 2), 878 (Tier 3), 1,167 (Tier 4), and 512 (Tier 5). 7,895 members are enrolled in Indiana, and 296,967 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $4 (preferred generic), $10 (generic), $45 (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $2 (generic), $135 (preferred brand), and 50% (non-preferred).
Cigna Saver Rx – $12.20 monthly premium with $505 deductible and 3,289 available formulary drugs. Available drugs are 232 (Tier 1), 360 (Tier 2), 1,195 (Tier 3), 997 (Tier 4), and 505 (Tier 5). Member information not available. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $0 (preferred generic), $10 (generic), $40 (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $6 (generic), $120 (preferred brand), and 50% (non-preferred).
Cigna Secure Rx – $27.80 monthly premium with $505 deductible and 3,162 available formulary drugs. Available drugs are 142 (Tier 1), 489 (Tier 2), 774 (Tier 3), 1,231 (Tier 4), and 494 (Tier 5). 31,118 members are enrolled in Indiana, and 845,937 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $5 (generic), $20 (preferred brand), and 49% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $0 (generic), $60 (preferred brand), and 49% (non-preferred).
Clear Spring Health Premier Rx – $20.60 monthly premium with $505 deductible and 3,169 available formulary drugs. Available drugs are 215 (Tier 1), 502 (Tier 2), 795 (Tier 3), 1,076 (Tier 4), and 581 (Tier 5). 1,817 members are enrolled in Indiana, and 119,646 members are enrolled countrywide. The Plan Summary Star Rating is 1.5. 30-day preferred pharmacy drug copays are $1 (preferred generic), $5 (generic), $42 (preferred brand), and 45% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $3 (preferred generic), $15 (generic), $126 (preferred brand), and 45% (non-preferred).
Clear Spring Health Value Rx – $22.60 monthly premium with $505 deductible and 3,125 available formulary drugs. Available drugs are 196 (Tier 1), 534 (Tier 2), 585 (Tier 3), 1,242 (Tier 4), and 568 (Tier 5). 4,248 members are enrolled in Indiana, and 201,352 members are enrolled countrywide. The Plan Summary Star Rating is 1.5. 30-day preferred pharmacy drug copays are $1 (preferred generic), $3 (generic), $42 (preferred brand), and 35% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $3 (preferred generic), $9 (generic), $126 (preferred brand), and 35% (non-preferred).
Elixir RxPlus – $41.40 monthly premium with $505 deductible and 3,074 available formulary drugs. Available drugs are 99 (Tier 1), 605 (Tier 2), 595 (Tier 3), 1,184 (Tier 4), and 598 (Tier 5). 387 members are enrolled in Indiana, and 198,886 members are enrolled countrywide. The Plan Summary Star Rating is 2.5. 30-day preferred pharmacy drug copays are $1 (preferred generic), $6 (generic), $43 (preferred brand), and 47% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $6 (generic), $86 (preferred brand), and 47% (non-preferred).
Elixir RxSecure – $41.60 monthly premium with $505 deductible and 2,989 available formulary drugs. Available drugs are 99 (Tier 1), 594 (Tier 2), 574 (Tier 3), 1,150 (Tier 4), and 579 (Tier 5). 433 members are enrolled in Indiana, and 444,496 members are enrolled countrywide. The Plan Summary Star Rating is 2.5. 30-day preferred pharmacy drug copays are $1 (preferred generic), $4 (generic), 15% (preferred brand), and 40% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $6 (generic), 15% (preferred brand), and 40% (non-preferred).
Humana Basic Rx Plan – $30.70 monthly premium with $505 deductible and 3,135 available formulary drugs. Available drugs are 145 (Tier 1), 638 (Tier 2), 756 (Tier 3), 1,032 (Tier 4), and 564 (Tier 5). 11,465 members are enrolled in Indiana, and 1,206,799 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $0 (preferred generic), $1 (generic), 19% (preferred brand), and 41% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $0 (generic), 15% (preferred brand), and 30% (non-preferred).
Humana Premier Rx Plan – $80.20 monthly premium with $300 deductible and 3,244 available formulary drugs. Available drugs are 277 (Tier 1), 556 (Tier 2), 763 (Tier 3), 1,073 (Tier 4), and 575 (Tier 5). 23,555 members are enrolled in Indiana, and 872,688 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $4 (generic), $45 (preferred brand), and 49% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $0 (generic), $125 (preferred brand), and 49% (non-preferred).
Humana Walmart Value Rx – $30.60 monthly premium with $505 deductible and 3,178 available formulary drugs. Available drugs are 157 (Tier 1), 667 (Tier 2), 721 (Tier 3), 1,059 (Tier 4), and 574 (Tier 5). 34,062 members are enrolled in Indiana, and 1,338,693 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $2 (generic), 18% (preferred brand), and 38% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $3 (preferred generic), $6 (generic), 18% (preferred brand), and 38% (non-preferred).
Mutual Of Omaha Rx Essential – $19.00 monthly premium with $505 deductible and 3,132 available formulary drugs. Available drugs are 158 (Tier 1), 748 (Tier 2), 736 (Tier 3), 927 (Tier 4), and 563 (Tier 5). 188 members are enrolled in Indiana, and 872,688 members are enrolled countrywide. The Plan Summary Star Rating is 2.0. 30-day preferred pharmacy drug copays are $0 (preferred generic), $15 (generic), 20% (preferred brand), and 48% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $37.50 (generic), 20% (preferred brand), and n/a (non-preferred).
Mutual Of Omaha Rx Plus – $85.10 monthly premium with $505 deductible and 3,109 available formulary drugs. Available drugs are 158 (Tier 1), 764 (Tier 2), 718 (Tier 3), 905 (Tier 4), and 564 (Tier 5). 159 members are enrolled in Indiana, and 15,840 members are enrolled countrywide. The Plan Summary Star Rating is 2.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $5 (generic), 20% (preferred brand), and 38% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $2.50 (preferred generic), $12.50 (generic), 20% (preferred brand), and n/a (non-preferred).
Mutual Of Omaha Rx Premier – $61.90 monthly premium with $505 deductible and 3,015 available formulary drugs. Available drugs are 137 (Tier 1), 581 (Tier 2), 707 (Tier 3), 1,089 (Tier 4), and 501 (Tier 5). 1,538 members are enrolled in Indiana, and 91,045 members are enrolled countrywide. The Plan Summary Star Rating is 2.0. 30-day preferred pharmacy drug copays are $1 (preferred generic), $10 (generic), $45 (preferred brand), and 45% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $2.50 (preferred generic), $25 (generic), $112.50 (preferred brand), and n/a (non-preferred).
SilverScript Choice – $27.80 monthly premium with $505 deductible and 3,486 available formulary drugs. Available drugs are 250 (Tier 1), 1,200 (Tier 2), 243 (Tier 3), 1,243 (Tier 4), and 550 (Tier 5). 59,372 members are enrolled in Indiana, and 3,035,101 members are enrolled countrywide. The Plan Summary Star Rating is 3.5. 30-day preferred pharmacy drug copays are $2 (preferred generic), $7 (generic), 17% (preferred brand), and 37% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $6 (preferred generic), $21 (generic), 17% (preferred brand), and 37% (non-preferred).
SilverScript Plus – $74.00 monthly premium with $0 deductible and 3,572 available formulary drugs. Available drugs are 250 (Tier 1), 1,201 (Tier 2), 312 (Tier 3), 1,237 (Tier 4), and 572 (Tier 5). 12,549 members are enrolled in Indiana, and 262,512 members are enrolled countrywide. The Plan Summary Star Rating is 3.5. 30-day preferred pharmacy drug copays are $0 (preferred generic), $0 (generic), $47 (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $0 (generic), $141 (preferred brand), and 50% (non-preferred).
SilverScript SmartSaver – $4.80 monthly premium with $505 deductible and 3,641 available formulary drugs. Available drugs are 250 (Tier 1), 1,174 (Tier 2), 229 (Tier 3), 1,399 (Tier 4), and 589 (Tier 5). 48,855 members are enrolled in Indiana, and 1,455.393 members are enrolled countrywide. The Plan Summary Star Rating is 3.5. 30-day preferred pharmacy drug copays are $2 (preferred generic), $15 (generic), 25% (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $6 (preferred generic), $45 (generic), 25% (preferred brand), and 50% (non-preferred).
Wellcare Classic – $27.90 monthly premium with $505 deductible and 3,057 available formulary drugs. Available drugs are 129 (Tier 1), 421 (Tier 2), 1,059 (Tier 3), 876 (Tier 4), and 572 (Tier 5). 27,385 members are enrolled in Indiana, and 1,379,312 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $0 (preferred generic), $4 (generic), $32 (preferred brand), and 38% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $12 (generic), $96 (preferred brand), and 38% (non-preferred).
Wellcare Medicare Rx Value Plus – $71.30 monthly premium with $0 deductible and 3,449 available formulary drugs. Available drugs are 343 (Tier 1), 384 (Tier 2), 1,036 (Tier 3), 991 (Tier 4), and 655 (Tier 5). 13,768 members are enrolled in Indiana, and 424,283 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $0 (preferred generic), $4 (generic), $47 (preferred brand), and 50% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $10 (generic), $117.50 (preferred brand), and 50% (non-preferred).
Wellcare Value Script – $10.60 monthly premium with $505 deductible and 3,438 available formulary drugs. Available drugs are 322 (Tier 1), 399 (Tier 2), 1,012 (Tier 3), 1,010 (Tier 4), and 655 (Tier 5). 80,688 members are enrolled in Indiana, and 2,616,951 members are enrolled countrywide. The Plan Summary Star Rating is 3.0. 30-day preferred pharmacy drug copays are $0 (preferred generic), $5 (generic), $44 (preferred brand), and 47% (non-preferred). 90-day mail-order preferred pharmacy drug copays are $0 (preferred generic), $15 (generic), $132 (preferred brand), and 47% (non-preferred).