The information below is for research purposes. Enrollment in the 2022 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 | |||
---|---|---|---|---|---|---|---|---|
SilverScript SmartRx (PDP) (S5601-200) Benefit Details ![]() ![]() ![]() ![]() |
$6.80 | $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% | 3,629 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) (S4802-228) Benefit Details ![]() ![]() ![]() ![]() |
$68.90 | $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 | 3,486 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 | |||
---|---|---|---|---|---|---|---|---|
Wellcare Value Script (PDP) (S4802-158) Benefit Details ![]() ![]() ![]() ![]() |
$10.60 | $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% | 265,011 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript Choice (PDP) (S5601-050) Benefit Details ![]() ![]() ![]() ![]() |
$34.80 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 17% Non-Preferred Drug: 38% Specialty Tier: 25% | 142,635 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-204) Benefit Details ![]() ![]() ![]() ![]() |
$22.70 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: 16% Non-Preferred Drug: 49% Specialty Tier: 25% | 131,026 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript SmartRx (PDP) (S5601-200) Benefit Details ![]() ![]() ![]() ![]() |
$6.80 | $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% | 125,543 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
MedicareBlue Rx Standard (PDP) (S5743-001) Benefit Details ![]() ![]() ![]() ![]() |
$82.80 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $10.00 Preferred Brand: $29.00 Non-Preferred Drug: 35% Specialty Tier: 25% | 115,950 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) (S5601-200) Benefit Details ![]() ![]() ![]() ![]() |
$6.80 | $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% | 3,629 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-158) Benefit Details ![]() ![]() ![]() ![]() |
$10.60 | $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 | 3,472 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Premier Rx (PDP) (S6946-051) Benefit Details ![]() ![]() ![]() ![]() |
$16.60 | $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% | 3,157 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-204) Benefit Details ![]() ![]() ![]() ![]() |
$22.70 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: 16% Non-Preferred Drug: 49% Specialty Tier: 25% | 3,265 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-406) Benefit Details ![]() ![]() ![]() ![]() |
$29.30 | $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% | 3,195 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Value Rx (PDP) (S6946-022) Benefit Details ![]() ![]() ![]() ![]() |
$29.30 | $480 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $42.00 Non-Preferred Drug: 40% Specialty Tier: 25% | 3,142 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. |