The information below is for research purposes. Enrollment in the 2015 plans is no longer available.
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance 30-Day Supply | Total Formulary Drugs | |||
---|---|---|---|---|---|---|---|---|
Humana Walmart Rx Plan (PDP) (S5884-169) Benefit Details ![]() ![]() ![]() ![]() |
$15.70 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 3,433 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
SilverScript Choice (PDP) (S5601-046) Benefit Details ![]() ![]() ![]() ![]() |
$23.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $33.00 Non-Preferred Brand: 46% Specialty Tier: 33% | 3,043 Browse Formulary | |||
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance |
State Members | |||
---|---|---|---|---|---|---|---|---|
SilverScript Choice (PDP) (S5601-046) Benefit Details ![]() ![]() ![]() ![]() |
$23.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $33.00 Non-Preferred Brand: 46% Specialty Tier: 33% | 63,234 Browse Formulary | |||
AARP MedicareRx Preferred (PDP) (S5820-022) Benefit Details ![]() ![]() ![]() ![]() |
$54.90 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | 33,657 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Blue Cross MedicareRx Value (PDP) (S5715-010) Benefit Details ![]() ![]() ![]() ![]() |
$54.80 | $275 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $6.00 Preferred Brand: $37.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | 25,710 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-144) Benefit Details ![]() ![]() ![]() ![]() |
$28.60 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $2.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 24,012 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-169) Benefit Details ![]() ![]() ![]() ![]() |
$15.70 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 19,083 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
Humana Walmart Rx Plan (PDP) (S5884-169) Benefit Details ![]() ![]() ![]() ![]() |
$15.70 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 3,433 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript Choice (PDP) (S5601-046) Benefit Details ![]() ![]() ![]() ![]() |
$23.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $33.00 Non-Preferred Brand: 46% Specialty Tier: 33% | 3,043 Browse Formulary | |||
Aetna Medicare Rx Saver (PDP) (S5810-057) Benefit Details ![]() ![]() ![]() ![]() |
$23.90 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $3.00 Preferred Brand: $45.00 Non-Preferred Brand: 37% Specialty Tier: 25% | 3,062 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SmartD Rx Saver (PDP) (S0064-023) Benefit Details ![]() ![]() ![]() ![]() |
$26.40 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $2.00 Preferred Brand: 23% Non-Preferred Brand: 45% Specialty Tier: 25% | 3,395 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Saver Plus (PDP) (S5921-368) Benefit Details ![]() ![]() ![]() ![]() |
$28.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $2.00 Preferred Brand: $20.00 Non-Preferred Brand: $40.00 Specialty Tier: 25% | 3,510 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Blue Cross MedicareRx Basic (PDP) (S5715-015) Benefit Details ![]() ![]() ![]() ![]() |
$28.10 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $6.00 Preferred Brand: $39.00 Non-Preferred Brand: $90.00 Specialty Tier: 25% | 2,523 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-144) Benefit Details ![]() ![]() ![]() ![]() |
$28.60 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $2.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 3,307 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
EnvisionRxPlus Silver (PDP) (S7694-023) Benefit Details ![]() ![]() ![]() ![]() |
$28.90 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Preferred Brand: 15% Non-Preferred Brand: 25% Specialty Tier: 25% | 2,971 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna-HealthSpring Rx Secure (PDP) (S5617-113) Benefit Details ![]() ![]() ![]() ![]() |
$29.90 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $3.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 3,335 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Symphonix Value Rx (PDP) (S0522-040) Benefit Details ![]() ![]() ![]() ![]() |
$30.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Non-Preferred Generic: $4.00 Preferred Brand: $25.00 Non-Preferred Brand: $70.00 Specialty Tier: 25% | 3,529 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
A few notes to help with the understanding of the 2015 Medicare Part D Plan chart above.
(Chart Source: Centers for Medicare and Medicaid file 2015 PDP Landscape Source file) Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information. Through the application process we will provide you with the most up-to-the-minute information/pricing. |