_dta: 1. maa_to_m2015 data set up by Jean Roth , jroth@nber.org , 17 May 2015 2. Excel file 2015LandscapeSource file MA 11042014.xls 3. Sheet MA (States A to M) 4. 2015 Medicare Advantage, and Cost Plans 5. Data as of September 2, 2014 (updated on November 4, 2014). Includes 2015 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. Medicare/Medicaid plans are shown in a separate Landscape file. 6. Notes: Data are subject to change as contracts are finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit. 7. * Indicates plan does not offer Part D drug coverage. 8. ** MOOP is defined as: Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. N/A is defined as Not Applicable 9. man_to_w2015 data set up by Jean Roth , jroth@nber.org , 17 May 2015 10. Sheet MA (states N to W) 11. planreporta_to_m2015 data set up by Jean Roth , jroth@nber.org , 17 May 2015 12. Excel file Medicare Part D 2015 Plan Report 11042014.xls 13. Sheet Alabama to Montana 14. Important Notes: 15. 1 This file includes contracts/plans as of September 5, 2014 (updated November 4, 2014). The data does not reflect information for Employer sponsored plans, Part B only plans, Medicare/Medicaid plans, or plans not offering a Part D drug benefit (Medicare Advantage only plans, HCCP Cost plans, etc.). 16. 2 Part C Premium: The Part C premium for Medicare Advantage Plans, Cost Plans, and Demonstrations covers Medicare medical and hospital benefits, and supplemental benefits, where offered. Beneficiaries generally are also responsible for the Part B premium. 17. 3 Part D Basic Premium: The Part D Basic Premium covers the basic prescription benefit only and does not cover enhanced drug benefits, medical benefits, or hospital benefits. Note: the Part D Basic Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans. Beneficiaries are also responsible for their Part B premium and any premiums for Medigap coverage to meet their individual needs. 18. 4 Part D Supplemental Premium: The Part D Supplemental Premium covers any enhanced benefits that may be offered by a plan above and beyond the basic (standard) Part D benefit. These benefits may include extra coverage in the coverage gap, lower copayments than the standard benefit, coverage of non-Part D drugs. Note: the Part D Supplemental Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans. 19. 5 Part D Total Premium: Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the supplemental premium due to a negative basic premium. 20. 6 Part D Premium Obligation with Full Premium Assistance: This column indicates the total Part D premium a beneficiary receiving a full low-income subsidy would pay for a plan. If column M, with the header "Part D Basic Premium Below Regional Benchmark?" in the states tabs, is listed as "Below Regional Benchmark" and the Part D Premium Obligation with Full Premium Assistance is <$2.00, then that portion is waived by the plan. 21. 7 Tiers Not Subject to Deductible: In 2015, plans can indicate tiers where the deductible does not apply. This is a flag to capture instances where the plan has some tiers that are exempt from the deductible. 22. 8 Increased Initial Coverage Limit: The Increased Initial Coverage Limit column specifies (with a "Yes") any plans that have increased the initial coverage limit applicable to Part D drugs (from the standard $2,960). 23. 2015 Plan and Premium Information for Medicare Plans Offering Part D Coverage 24. Alabama to Montana. Includes contracts/plans as of September 2, 2014 (updated November 4, 2014). The data does not reflect information for Employer sponsored plans, Part B only plans, Medicare/Medicaid plans, or plans not offering a Part D drug benefit.1 25. * See next worksheet for important footnotes. 26. planreportn_to_w2015 data set up by Jean Roth , jroth@nber.org , 17 May 2015 27. Sheet Nebraska to Wyoming 28. maa_to_m2014 data set up by Jean Roth , jroth@nber.org , 17 May 2015 29. Excel file 2014LandscapeSource file MA 05292014.xls 30. 2014 Medicare Advantage, and Cost Plans 31. Data as of June 1, 2014. Includes 2014 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. Medicare/Medicaid plans are shown in a separate Landscape file. 32. Notes: Data are subject to change as contracts are finalized. For 2014, enhanced alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above and beyond the 2014 standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs. Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows: “All”: 100% of formulary drugs are covered through the gap, “Many”: ≥65% to <100% of formulary drugs are covered through the gap, “Some”: ≥10% to <65 % of formulary drugs are covered through the gap, “Few”: >0% to <10% of formulary drugs are covered through the gap (and must also be >15 "brand" products covered through the gap), “No Gap Coverage”: 0% of formulary drugs are covered through the gap (or ≤15 "brand" products covered through the gap). A label of “All Formulary Drugs” is applied for plans that cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit). 33. man_to_w2014 data set up by Jean Roth , jroth@nber.org , 17 May 2015 34. planreporta_to_m2014 data set up by Jean Roth , jroth@nber.org , 17 May 2015 35. Excel file Medicare Part D 2014 Plan Report 05292014.xls 36. 1 This file includes contracts/plans as of June 1, 2014. The data does not reflect information for Employer sponsored plans, Part B only plans, Medicare/Medicaid plans, or plans not offering a Part D drug benefit (Medicare Advantage only plans, HCCP Cost plans, etc.). 37. 5 Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums. 38. 7 Tiers Not Subject to Deductible: In 2014, plans can indicate tiers where the deductible does not apply. This is a flag to capture instances where the plan has some tiers that are exempt from the deductible. 39. 8 Increased Initial Coverage Limit: The Increased Initial Coverage Limit column specifies (with a "Yes") any plans that have increased the initial coverage limit applicable to Part D drugs (from the standard $2,850). Plans that have eliminated the initial coverage limit entirely are not displayed as "Yes" in this column, but are denoted as "All Formulary Drugs" as the type of coverage offered in the coverage gap. 40. 2014 Plan and Premium Information for Medicare Plans Offering Part D Coverage 41. Alabama to Montana. Includes contracts/plans as of June 1, 2014. The data does not reflect information for Employer sponsored plans, Part B only plans, Medicare/Medicaid plans, or plans not offering a Part D drug benefit.1 42. planreportn_to_w2014 data set up by Jean Roth , jroth@nber.org , 17 May 2015 43. maa_to_m2013 data set up by Jean Roth , jroth@nber.org , 17 May 2015 44. Excel file 2013LandscapeSource file MA 11212012.xls 45. 2013 Medicare Advantage, and Cost Plans 46. Data as of November 21, 2012. Includes 2013 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, Medicare/Medicaid plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. 47. Notes: Data are subject to change as contracts are finalized. For 2013, enhanced alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above and beyond the 2013 standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs. Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows: “All”: 100% of formulary drugs are covered through the gap, “Many”: ≥65% to <100% of formulary drugs are covered through the gap, “Some”: ≥10% to <65 % of formulary drugs are covered through the gap, “Few”: >0% to <10% of formulary drugs are covered through the gap (and must also be >15 products covered through the gap), “No Gap Coverage”: 0% of formulary drugs are covered through the gap (or ≤15 products covered through the gap). A label of “All Formulary Drugs” is applied for plans that cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit). 48. man_to_w2013 data set up by Jean Roth , jroth@nber.org , 17 May 2015 49. planreporta_to_m2013 data set up by Jean Roth , jroth@nber.org , 17 May 2015 50. Excel file Medicare Part D 2013 Plan Report 04252013v1.xls 51. 1 This file includes contracts/plans as of April 25, 2013. The data does not reflect information for Employer sponsored plans, Part B only plans, Medicare/Medicaid plans, or plans not offering a Part D drug benefit (Medicare Advantage only plans, HCCP Cost plans, etc.). 52. 4 Part D Supplemental Premium: The Part D Supplemental Premium covers any enhanced benefits that may be offered by a plan above and beyond the basic (standard) Part D benefit. These benefits may include extra coverage in the coverage gap, lower copayments than the standard benefit, coverage of non-Part D drugs (e.g. benzodiazepines), etc. Note: the Part D Supplemental Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans. 53. 6 Part D Premium Obligation with Full Premium Assistance: This column indicates the total Part D premium a beneficiary receiving a full low-income subsidy would pay for a plan. If column M, with the header "Part D Basic Premium Below Regional Benchmark?" in the states tabs, is listed as "Below Regional Benchmark" and the Part D Premium Obligation with Full Premium Assistance is <$2.05, then that portion is waived by the plan. 54. 7 Tiers Not Subject to Deductible: In 2013, plans can indicate tiers where the deductible does not apply. This is a flag to capture instances where the plan has some tiers that are exempt from the deductible. 55. 8 Increased Initial Coverage Limit: The Increased Initial Coverage Limit column specifies (with a "Yes") any plans that have increased the initial coverage limit applicable to Part D drugs (from the standard $2,930). Plans that have eliminated the initial coverage limit entirely are not displayed as "Yes" in this column, but are denoted as "All Formulary Drugs" as the type of coverage offered in the coverage gap. 56. 2013 Plan and Premium Information for Medicare Plans Offering Part D Coverage 57. Alabama to Montana. Includes contracts/plans as of April 25, 2013. The data does not reflect information for Employer sponsored plans, Part B only plans, Medicare/Medicaid plans, or plans not offering a Part D drug benefit.1 58. planreportn_to_w2013 data set up by Jean Roth , jroth@nber.org , 17 May 2015 59. maa_to_m2012 data set up by Jean Roth , jroth@nber.org , 17 May 2015 60. Excel file 2012LandscapeSourceData_MA_3_08_12.xls 61. 2012 Medicare Advantage, and Cost Plans 62. Data as of March 8, 2012. Includes all 2012 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. 63. Notes: Data are subject to change as contracts are finalized. For 2012, enhanced alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above and beyond the 2012 standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs. Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows: “All”: 100% of formulary drugs are covered through the gap, “Many”: ≥65% to <100% of formulary drugs are covered through the gap, “Some”: ≥10% to <65 % of formulary drugs are covered through the gap, “Few”: >0% to <10% of formulary drugs are covered through the gap (and must also be >15 products covered through the gap), “No Gap Coverage”: 0% of formulary drugs are covered through the gap (or ≤15 products covered through the gap). A label of “All Formulary Drugs” is applied for plans that cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit). 64. man_to_w2012 data set up by Jean Roth , jroth@nber.org , 17 May 2015 65. Sheet MA (States N to W) 66. planreporta_to_m2012 data set up by Jean Roth , jroth@nber.org , 17 May 2015 67. Excel file Medicare Part D 2012 Plan Report 09-08-11.xls 68. 1 This file includes contracts/plans as of September 8, 2011. The data does not reflect information for Employer sponsored plans, Part B only plans, or plans not offering a Part D drug benefit (Medicare Advantage only plans, HCCP Cost plans, etc.). 69. 6 Part D Premium Obligation with Full Premium Assistance: This column indicates the total Part D premium a beneficiariy receiving a full low-income subsidy would pay for a plan. 70. 7 Tiers Not Subject to Deductible: In 2012, plans can indicate tiers where the deductible does not apply. This is a flag to capture instances where the plan has some tiers that are exempt from the deductible. 71. 8 Increased Initial Coverage Limit: The Increased Initial Coverage Limit column specifies (with a "Yes") any plans that have increased the initial coverage limit applicable to Part D drugs (from the standard $2,930). Plans that have eliminated the intial coverage limit entirely are not displayed as "Yes" in this column, but are denoted as "All Formulary Drugs" as the type of coverage offed in the coverage gap. 72. 2012 Plan and Premium Information for Medicare Plans Offering Part D Coverage 73. Alabama to Montana. Includes contracts/plans as of September 8, 2011. The data does not reflect information for Employer sponsored plans, Part B only plans, or plans not offering a Part D drug benefit.1 74. planreportn_to_w2012 data set up by Jean Roth , jroth@nber.org , 17 May 2015 75. maa_to_m2011 data set up by Jean Roth , jroth@nber.org , 17 May 2015 76. Excel file PrintReady_2011LandscapeSourceData_MA_12_17_10.xls 77. 2011 Medicare Advantage, and Cost Plans 78. Data as of December 17, 2010. Includes all 2011 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. 79. Notes: Data are subject to change as contracts are finalized. For 2011, enhanced alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above and beyond the 2011 standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs. Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows: “All”: 100% of formulary drugs are covered through the gap, “Many”: ≥65% to <100% of formulary drugs are covered through the gap, “Some”: ≥10% to <65 % of formulary drugs are covered through the gap, “Few”: >0% to <10% of formulary drugs are covered through the gap (and must also be >15 products covered through the gap), “No Gap Coverage”: 0% of formulary drugs are covered through the gap (or ≤15 products covered through the gap). A label of “All Formulary Drugs” is applied for plans that cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit). 80. man_to_w2011 data set up by Jean Roth , jroth@nber.org , 17 May 2015 81. planreporta_to_m2011 data set up by Jean Roth , jroth@nber.org , 17 May 2015 82. Excel file Medicare Part D 2011 Plan Report 09-15-10.xls 83. 1 This file includes contracts/plans as of September 15, 2010. The data does not reflect information for Employer sponsored plans, Part B only plans, or plans not offering a Part D drug benefit (Medicare Advantage only plans, HCCP Cost plans, etc.). 84. 7 Tiers Not Subject to Deductible: In 2011, plans can indicate tiers where the deductible does not apply. This is a flag to capture instances where the plan has some tiers that are exempt from the deductible. 85. 8 Increased Initial Coverage Limit: The Increased Initial Coverage Limit column specifies (with a "Yes") any plans that have increased the initial coverage limit applicable to Part D drugs (from the standard $2,840). Plans that have eliminated the intial coverage limit entirely are not displayed as "Yes" in this column, but are denoted as "All Formulary Drugs" as the type of coverage offed in the coverage gap. 86. 2011 Plan and Premium Information for Medicare Plans Offering Part D Coverage 87. Alabama to Montana. Includes contracts/plans as of September 15, 2010. The data does not reflect information for Employer sponsored plans, Part B only plans, or plans not offering a Part D drug benefit.1 88. planreportn_to_w2011 data set up by Jean Roth , jroth@nber.org , 17 May 2015 89. maa_to_m2010 data set up by Jean Roth , jroth@nber.org , 17 May 2015 90. Excel file 2010LandscapeSourceData_MA_12_01_09.xls 91. 2010 Medicare Advantage, Cost, and Demonstration Plans 92. Data as of December 1, 2009. Includes all contracts/plans regardless of 2010 approval status. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. 93. Notes: Data are subject to change as contracts are being finalized. Gap coverage descriptions for the 2010 benefit year are have been revised. The percentage of “Generic” products and the percentage of “Brand” products covered in the gap are each separately calculated and the following descriptions are added: “All”: 100% of drugs are covered through the gap, “Many”: ≥65% to <100% of drugs are covered through the gap, “Some”: ≥10% to <65 % of drugs are covered through the gap, “Few”: >0% to <10% of drugs are covered through the gap (and must also be >15 products covered through the gap), “No Gap Coverage”: 0% of drugs are covered through the gap (or ≤15 products covered through the gap). A label of “All Formulary Drugs” is applied for plans that cover 100% of “Generic” and 100% of “Brand” products (either by covering all drug products in the gap or by having no initial coverage limit). 94. man_to_w2010 data set up by Jean Roth , jroth@nber.org , 17 May 2015 obs: 461,153 vars: 41 17 May 2015 16:32 size: 278,536,412 (_dta has notes) ------------------------------------------------------------------------------------------------------------------------------------------------- storage display value variable name type format label variable label ------------------------------------------------------------------------------------------------------------------------------------------------- state str24 %24s State county str25 %25s County organizationname str50 %50s Organization Name planname str72 %72s Plan Name typeofmedicarehealthplan str14 %14s Type of Medicare Health Plan monthlyconsolidatedpremiumi double %14.2f Monthly Consolidated Premium (Includes Part C + D) annualdrugdeductible int %14.2f Annual Drug Deductible drugbenefittype str8 %9s Drug Benefit Type additionalcoverageofferedin str3 %9s Additional Coverage Offered in the Gap drugbenefittypedetail str2 %9s Drug Benefit Type Detail contractid str5 %9s Contract ID planid str3 %9s Plan ID segmentid str2 %9s Segment ID innetworkmoopamount double %10.0g In-network MOOP Amount ** overallstarrating double %10.0g Overall Star Rating overallstarratingstr str43 %43s Overall Star Rating organizationtype str13 %13s Organization Type plantype str31 %31s Plan Type specialneedsplan str3 %9s Special Needs Plan specialneedsplantype str30 %30s Special Needs Plan Type benefittype str31 %31s Benefit Type partdbasicpremiumbelowregio str24 %24s Part D Basic Premium Below Regional Benchmark? nationalpdp str1 %9s National PDP partcpremium double %10.0g Part C Premium2 partdbasicpremium double %10.0g Part D Basic Premium3 partdsupplementalpremium double %10.0g Part D Supplemental Premium4 partdtotalpremium double %10.0g Part D Total Premium5 partdpremiumobligationwithf double %10.0g Part D Premium Obligation with Full Premium Assistance6 partdpremiumobligationwith75prem double %10.0g Part D Premium Obligation with 75% Premium Assistance partdpremiumobligationwith50prem double %10.0g Part D Premium Obligation with 50% Premium Assistance partdpremiumobligationwith25prem double %10.0g Part D Premium Obligation with 25% Premium Assistance partddrugdeductible int %10.0g Part D Drug Deductible tiersnotsubjecttodeductible byte %10.0g Tiers Not Subject to Deductible7 increasedinitialcoveragelimit str1 %9s Increased Initial Coverage Limit8 extracoverageingap str1 %9s Extra Coverage in Gap typeofadditionalcoverageoff str29 %29s Type of Additional Coverage Offered in the Gap typeofextracoverageinthega str29 %29s Type of Extra Coverage in the Gap preventiveservicesprovidedat str3 %9s Preventive Services Provided at Zero Cost Share typeofextracoverageoffered str25 %25s Type of Extra Coverage Offered in the Gap demotype str36 %36s Demo Type moop3400coveringallmedic str3 %9s MOOP≤$3,400 Covering all Medicare Benefits ------------------------------------------------------------------------------------------------------------------------------------------------- Sorted by: state county contractid planid segmentid