MedicarePartD.guide

A non-government resource built from CMS public data

Horizon Medicare Blue Rx Enhanced (PDP)

Contract S5993, plan 003, segment 0 · offered by HORIZON INSURANCE COMPANY · CMS PDP Region 04 (New Jersey).

Plan features

Monthly premium$139.10
Annual deductible$200.00Tier 1 and 2 exempt
Drug benefit type—
$0 premium with full LIS—
Premium with Extra Help (LIS)—
Formulary drugs3,464
Formulary exception tier—
Mail order offered—
Plan reach—
Members in New Jersey—
Members nationally—
Member services—
BIN / PCN—

CMS star ratings

Summary rating
3.5 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$6.00—
Tier 320%—
Tier 445%—
Tier 530%—

Cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial deductible phase
Tier 1: Preferred Generic$0.00$0.00$0.00$0.00$0.00$0.00
Tier 2: Generic$6.00$6.00$3.00$18.00$18.00$9.00
Initial coverage phase
Tier 1: Preferred Generic$0.00$0.00$0.00$0.00$0.00$0.00
Tier 2: Generic$6.00$6.00$3.00$18.00$18.00$9.00
Tier 3: Preferred Brand20%20%20%20%20%20%
Tier 4: Non-Preferred Drug45%45%45%45%45%45%
Tier 5: Specialty Tier30%30%n/an/an/an/a
Catastrophic coverage phase
Tier 1: Preferred Generic$0.00$0.00$0.00$0.00$0.00$0.00
Tier 2: Generic$0.00$0.00$0.00$0.00$0.00$0.00
Tier 3: Preferred Brand$0.00$0.00$0.00$0.00$0.00$0.00
Tier 4: Non-Preferred Drug$0.00$0.00$0.00$0.00$0.00$0.00
Tier 5: Specialty Tier$0.00$0.00$0.00$0.00$0.00$0.00