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Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance 30-Day Supply | Total Formulary Drugs | |||
---|---|---|---|---|---|---|---|---|
SilverScript SmartRx (PDP) (S5601-192) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$6.90 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 25% | 3,601 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 | |||
---|---|---|---|---|---|---|---|---|
Wellcare Medicare Rx Value Plus (PDP) (S4802-220) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$68.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 33% select insulin pay $35 copay | 3,464 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 |
State Members | |||
---|---|---|---|---|---|---|---|---|
SilverScript Choice (PDP) (S5601-034) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$27.10 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 17% Non-Preferred Drug: 40% Specialty Tier: 25% | 121,425 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-151) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$11.70 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $42.00 Non-Preferred Drug: 47% Specialty Tier: 25% | 99,973 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Blue Cross MedicareRx Value (PDP) (S5715-001) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$85.20 | $480 | Yes, some additional gap coverage. | Preferred Generic: $1.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: 41% Specialty Tier: 25% | 93,628 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Preferred (PDP) (S5820-016) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$94.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Drug: 40% Specialty Tier: 33% | 70,940 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript SmartRx (PDP) (S5601-192) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$6.90 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 25% | 54,579 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 SmartRx (PDP) (S5601-192) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$6.90 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 25% | 3,601 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-151) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$11.70 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $42.00 Non-Preferred Drug: 47% Specialty Tier: 25% select insulin pay $35 copay | 3,450 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Premier Rx (PDP) (S6946-043) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.70 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 45% Specialty Tier: 25% | 3,160 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Blue Cross MedicareRx Choice (PDP) (S5715-019) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$20.20 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $44.00 Non-Preferred Drug: 38% Specialty Tier: 25% | 3,019 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-196) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$22.70 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 16% Non-Preferred Drug: 42% Specialty Tier: 25% | 3,221 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Classic (PDP) (S4802-087) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.20 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $6.00 Preferred Brand: $39.00 Non-Preferred Drug: 40% Specialty Tier: 25% | 3,110 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Value Rx (PDP) (S6946-014) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.50 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $42.00 Non-Preferred Drug: 37% Specialty Tier: 25% | 3,147 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript Choice (PDP) (S5601-034) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$27.10 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 17% Non-Preferred Drug: 40% Specialty Tier: 25% | 3,108 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Saver Plus (PDP) (S5921-362) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$27.40 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $9.00 Preferred Brand: $40.00 Non-Preferred Drug: 40% Specialty Tier: 25% | 3,165 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-398) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$27.60 | $310 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: 40% Specialty Tier: 27% | 3,166 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna Secure Rx (PDP) (S5617-224) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.00 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $45.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00 | 3,190 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Basic Rx Plan (PDP) (S5884-107) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.30 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 19% Non-Preferred Drug: 40% Specialty Tier: 25% | 3,104 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Elixir RxSecure (PDP) (S7694-017) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 15% Non-Preferred Drug: 28% Specialty Tier: 25% | 3,085 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
A few notes to help with the understanding of the 2022 Medicare Part D Plan chart above.
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. |