AARP Medicare Rx Saver from UHC (PDP)
Contract S5921, plan 360, segment 0 · offered by UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY · CMS PDP Region 15 (Indiana).
Plan features
| Monthly premium | $90.30 |
|---|---|
| Annual deductible | $615.00 |
| Drug benefit type | — |
| $0 premium with full LIS | — |
| Premium with Extra Help (LIS) | — |
| Formulary drugs | 3,132 |
| Formulary exception tier | — |
| Plan reach | — |
| Members in Indiana | at least 7,0534 counties suppressed by CMS (under 11 enrollees) |
| Members nationally | 11,517 |
| Member services | (866)460-8854TTY 711 |
| Pharmacy search | AARPMedicarePlans.com |
| BIN / PCN | 610097 / 9999See BIN/PCNs for all plans |
CMS star ratings
- Part D summary rating
- 2 out of 5 stars for Part D summary rating
Published per contract, which is how CMS scores them — every plan under contract S5921 shares this rating.
Formulary tiers — preferred pharmacy, initial coverage phase
| Tier | Cost-sharing | Drugs on tier |
|---|---|---|
| Tier 1 | $2.00 | 54 |
| Tier 2 | $7.00 | 442 |
| Tier 3 | 17% | 969 |
| Tier 4 | 42% | 984 |
| Tier 5 | 25% | 683 |
Cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $2.00 | $8.00 | n/a | $6.00 | $24.00 | $6.00 |
| Tier 2: Generic | $7.00 | $9.00 | n/a | $21.00 | $27.00 | $21.00 |
| Tier 3: Preferred Brand | 17% | 17% | n/a | 17% | 17% | 17% |
| Tier 4: Non-Preferred Drug | 42% | 45% | 42% | n/a | n/a | n/a |
| Tier 5: Specialty Tier | 25% | 25% | 25% | n/a | n/a | n/a |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | 0% | 0% | 0% | 0% | 0% | 0% |
| Tier 2: Generic | 0% | 0% | 0% | 0% | 0% | 0% |
| Tier 3: Preferred Brand | 0% | 0% | 0% | 0% | 0% | 0% |
| Tier 4: Non-Preferred Drug | 0% | 0% | 0% | 0% | 0% | 0% |
| Tier 5: Specialty Tier | 0% | 0% | 0% | 0% | 0% | 0% |
Plan facts come from the CMS quarterly prescription drug plan public use files.