MedicarePartD.guide

A non-government resource built from CMS public data

AARP Medicare Rx Saver from UHC (PDP)

Contract S5921, plan 375, segment 0 · offered by UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY · CMS PDP Region 31 (Utah).

Plan features

Monthly premium$56.50
Annual deductible$615.00
Drug benefit type—
$0 premium with full LIS—
Premium with Extra Help (LIS)—
Formulary drugs3,132
Formulary exception tier—
Mail order offered—
Plan reach—
Members in Utah—
Members nationally—
Member services—
BIN / PCN—

CMS star ratings

Summary rating
2 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$2.00—
Tier 2$8.00—
Tier 317%—
Tier 435%—
Tier 525%—

Cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial coverage phase
Tier 1: Preferred Generic$2.00$8.00n/a$6.00$24.00$6.00
Tier 2: Generic$8.00$10.00n/a$24.00$30.00$24.00
Tier 3: Preferred Brand17%17%n/a17%17%17%
Tier 4: Non-Preferred Drug35%38%35%n/an/an/a
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%