2009 Medicare Prescription Drug Plan Details | |||||
---|---|---|---|---|---|
Medicare Plan Name: | Aetna Medicare Rx Essentials by Aetna Medicare | ||||
State: | Wisconsin | ||||
Plan ID: | S5810 - 050 - 0 Click to see other plans | ||||
Member Services: | 1-877-238-6211 TTY users 1-888-760-4748 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
||||
Email a copy of the Aetna Medicare Rx Essentials benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $34.60 | ||||
Annual Deductible: | $200 | ||||
$0 Premium if LIS Benefits? | Yes, this plan does qualify for the $0 Premium. | ||||
Gap Coverage? | No Gap Coverage | ||||
Total Number of Formulary Drugs: | 5,374 drugs | Browse the Aetna Medicare Rx Essentials Formulary | |||
This plan has 5 drug tiers. See cost-sharing highlights below. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $0.00 | $12.00 | $30.00 | $71.00 | 25% |
• Number of Drugs per Tier: | 677 | 1491 | 434 | 2327 | 445 |
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in Wisconsin: | 7,976 members (CMS Region 16) | ||||
Number of Members enrolled in this plan nationally: | 212,397 members |