MedicarePartD.guide

A non-government resource built from CMS public data

AARP Medicare Rx Preferred from UHC (PDP)

Contract S5820, plan 038, segment 0 · offered by UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY · CMS PDP Region 39 (Virgin Islands).

Plan features

Monthly premium$114.80
Annual deductible$615.00
Drug benefit type—
$0 premium with full LIS—
Premium with Extra Help (LIS)—
Formulary drugs3,593
Formulary exception tier—
Plan reach—
Members in Virgin Islands4,774
Members nationally4,825
Member services(888)867-5575TTY 711
Pharmacy searchAARPMedicarePlans.com
BIN / PCN610097 / 9999See BIN/PCNs for all plans

CMS star ratings

Part D summary rating
3 out of 5 stars for Part D summary rating

Published per contract, which is how CMS scores them — every plan under contract S5820 shares this rating.

Formulary tiers — preferred pharmacy, initial coverage phase

TierCost-sharingDrugs on tier
Tier 125%267
Tier 225%632
Tier 325%1,040
Tier 425%952
Tier 525%702

Cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial coverage phase
Tier 1: Preferred Generic25%25%25%25%25%25%
Tier 2: Generic25%25%25%25%25%25%
Tier 3: Preferred Brand25%25%25%25%25%25%
Tier 4: Non-Preferred Drug25%25%25%25%25%25%
Tier 5: Specialty Tier25%25%25%25%25%25%
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%

Plan facts come from the CMS quarterly prescription drug plan public use files.