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2010 Medicare Prescription Drug Plan Benefit Details for the MediMax One (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2010 Medicare Prescription Drug Plan Details
Medicare Plan Name:MediMax One (PDP)
   by Preferred Medicare Choice, Inc.
State:Puerto Rico
Plan ID:S0043 - 009 - 0     Click to see other plans
Member Services:1-866-516-7700 TTY users 1-866-516-770
— 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 MediMax One (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$5.60
Annual Deductible:$310
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,830
Drug Benefit Type ❔Actuarially Equivalent Standard (AE)
Gap Coverage?No Gap Coverage
Total Number of Formulary Drugs:2,633 drugsBrowse the MediMax One (PDP) Formulary
This plan has 4 drug tiers. See cost-sharing highlights below.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$5.00$24.00$45.0025% 
• Number of Drugs per
  Tier:		1717607101208
Plan Offers Mail Order?Yes
Plan Type (Reach):Regional Plan
Number of Members enrolled in this plan in Puerto Rico:370 members     (CMS Region 38)
Number of Members enrolled in this plan nationally:370 members




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