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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 | |||
---|---|---|---|---|---|---|---|---|
Wellcare Value Script (PDP) (S4802-147) Benefits & Contact Info |
$0.50 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $11.00 | 3,387 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 | |||
---|---|---|---|---|---|---|---|---|
Farm Bureau Select Rx (PDP) (S2668-006) Benefits & Contact Info |
$76.70 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $9.00 Preferred Brand: $42.00 Non-Preferred Drug: 45% Specialty Tier: 33% | 3,062 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) (S4802-147) Benefits & Contact Info |
$0.50 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $11.00 | 110,705 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript Choice (PDP) (S5601-024) Benefits & Contact Info |
$50.00 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: 16% Non-Preferred Drug: 40% Specialty Tier: 25% | 54,857 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript SmartSaver (PDP) (S5601-187) Benefits & Contact Info |
$12.30 | $280 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 24% Non-Preferred Drug: 50% Specialty Tier: 29% | 47,012 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-191) Benefits & Contact Info |
$40.10 | $545 | Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 16% Non-Preferred Drug: 45% Specialty Tier: 25% | 46,337 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Wellcare Classic (PDP) (S4802-071) Benefits & Contact Info |
$36.10 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 21% Non-Preferred Drug: 41% Specialty Tier: 25% Select Care Drugs: $0.00 | 44,231 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 Value Script (PDP) (S4802-147) Benefits & Contact Info |
$0.50 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $11.00 | 3,387 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript SmartSaver (PDP) (S5601-187) Benefits & Contact Info |
$12.30 | $280 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 24% Non-Preferred Drug: 50% Specialty Tier: 29% | 3,634 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Cigna Saver Rx (PDP) (S5617-362) Benefits & Contact Info |
$20.70 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: 19% Non-Preferred Drug: 48% Specialty Tier: 25% | 3,268 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Mutual of Omaha Rx Essential (PDP) (S7126-114) Benefits & Contact Info |
$23.60 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: 20% Non-Preferred Drug: 48% Specialty Tier: 25% | 3,165 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: |
A few notes to help with the understanding of the 2024 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. |