MedicarePartD.guide

A non-government resource built from CMS public data

HealthSpring Assurance Rx (PDP)

Contract S5617, plan 214, segment 0 · offered by MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY · CMS PDP Region 05 (Washington D.C.).

Plan features

Monthly premium$32.60
Annual deductible$615.00
Drug benefit type—
$0 premium with full LIS—
Premium with Extra Help (LIS)—
Formulary drugs3,265
Formulary exception tier—
Mail order offered—
Plan reach—
Members in Washington D.C.—
Members nationally—
Member services—
BIN / PCN—

CMS star ratings

Summary rating
2.5 out of 5 stars for Summary rating
Customer service
—
Member experience
—
Drug pricing & patient safety
—

Formulary tiers — preferred pharmacy, initial coverage phase

TierCost-sharingDrugs on tier
Tier 1$0.00—
Tier 2$2.00—
Tier 322%—
Tier 430%—
Tier 525%—

Cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial coverage phase
Tier 1: Preferred Generic$0.00$4.00$0.00$0.00$12.00$0.00
Tier 2: Generic$2.00$12.00$2.00$6.00$36.00$2.00
Tier 3: Preferred Brand22%23%22%22%23%22%
Tier 4: Non-Preferred Drug30%32%30%30%32%30%
Tier 5: Specialty Tier25%25%25%n/an/an/a
Catastrophic coverage phase
Tier 1: Preferred Generic0%0%0%0%0%0%
Tier 2: Generic0%0%0%0%0%0%
Tier 3: Preferred Brand0%0%0%0%0%0%
Tier 4: Non-Preferred Drug0%0%0%0%0%0%
Tier 5: Specialty Tier0%0%0%0%0%0%