Medicare Part D Plan Payment

$179 / year

This dataset contains information by insurance companies contracts regarding average payment per member per month for Medicare Part D Plans.

Complexity

Medicare Part D plans offer prescription drug coverage to eligible patients. These are offered through private insurance companies that are contracted by Medicare, so costs and availability may differ between carriers and by location. Part D plans include the Prescription Drug Plans and Medicare Advantage Prescription Drug plans.

CMS releases summary Part C and Part D payment data after the reconciliation of Part C and Part D payments, as provided in 42 CFR
§422.504(n)(1) and 42 CFR §423.505(o)(1). Additional information on the summary Part C and Part D payment data that CMS releases, can be found in CMS April 15, 2011 final rule, “Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2012 and Other Changes,” published in the Federal Register at 76 FR 21432. The categories of data are expressed at a summary level only. In addition, in instances where the level of aggregation identified in a data category was determined to be potentially insufficient to provide adequate protection against any disaggregation, such data is not included in said category. Any risk-adjusted payment is standardized to a 1.0 risk score, meaning that the included numbers are equal to the average risk-adjusted amount divided by the average risk score.

Date Created

2012-02-23

Last Modified

2019-10-11

Version

2019-10-11

Update Frequency

Semiannual

Temporal Coverage

2017

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Part D, Medicare Part D Plans, Medicaid Plan D, Medicare

Other Titles

Average Per Member Per Month Part D Payment, Health Insurance Payment, Medicare Prescription Drug Plans, Insurance Companies Payments of Part D Plans

NameDescriptionTypeConstraints
Contract_NumberInsurance contract number, help identify the insurance planstring-
Plan_Benefit_PackageBenefit Package of the insurance plan the beneficiary is availing, help identify the insurance planstring-
Contract_NameName of insurance provider providing Part C medical cover for the beneficiarystring-
Organization_TypeType of organization providing the medical carestring-
Average_PartD_Direct_Subsidy_PMPM_PaymentAverage Part D direct subsidy per member per month payment for a part D plannumber-
Average_PartD_Risk_ScoreAverage Part D health risk score of the beneficiary is used to calculate the insurance premiums or payments of part D plannumberlevel : Ratio
Average_Reinsurance_PMPM_PaymentAverage reinsurance per member per month payment for a part D plannumber-
Average_Low_Income_Cost_Sharing_PMPM_PaymentAverage low income cost sharing per member per month payment for a part D plannumber-
Contract NumberPlan Benefit PackageContract NameOrganization TypeAverage PartD Direct Subsidy PMPM PaymentAverage PartD Risk ScoreAverage Reinsurance PMPM PaymentAverage Low Income Cost Sharing PMPM Payment
E0654801IBT VOLUNTARY EMPLOYEE BENEFITS TRUSTEmployer/Union Only Direct Contract PDP20.920.88726.49
E2630801C AND O EMPLOYEES' HOSPITAL ASSOCIATIONEmployer/Union Only Direct Contract PDP26.221.02226.48
E3014801PSERS HOP PROGRAMEmployer/Union Only Direct Contract PDP15.420.7826.48
E4744801MODOT/MSHP MEDICAL AND LIFE INSURANCE PLANEmployer/Union Only Direct Contract PDP18.80.84326.49
E7316801UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMSEmployer/Union Only Direct Contract PDP17.10.810999999999999926.48
H00221BUCKEYE COMMUNITY HEALTH PLAN, INC.Demo61.031.676119.95187.89
H00284CHA HMO, INC.Local CCP23.480.907999999999999935.0826.27
H00287CHA HMO, INC.Local CCP44.571.79241.97210.62
H00288CHA HMO, INC.Local CCP25.741.01158.5542.02
H00621SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC.Local CCP33.011.28676.5764.04