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2011 Medicare Prescription Drug Plan Benefit Details for the EnvisionRxPlus Silver (PDP) - S7694-005
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2011 Medicare Prescription Drug Plan Details
Medicare Plan Name:EnvisionRxPlus Silver (PDP)
   by EnvisionRx Plus
State:Washington DC
Plan ID:S7694 - 005 - 0     Click to see other plans
Member Services:1-866-250-2005 TTY users 1-866-763-9630
— 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 EnvisionRxPlus Silver (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$35.30
Annual Deductible:$310
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,840
Drug Benefit Type ❔Defined Standard (DS)
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:2,388 drugsBrowse the EnvisionRxPlus Silver (PDP) Formulary
This plan has 5 drug tiers. See cost-sharing highlights below.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		25%25%25%25%25%
• Number of Drugs per
  Tier:		1241300294354199
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in your CMS Region:313 members     (CMS Region 05)
Number of Members enrolled in this plan nationally:118,250 members




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