2011 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Health Net Orange Option 2 (PDP) by Health Net | ||||
State: | North Carolina | ||||
Plan ID: | S5678 - 021 - 0 Click to see other plans | ||||
Member Services: | 1-800-806-8811 TTY users 1-800-929-9955 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
— This plan was sanctioned in 2011 — | |||||
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 |
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Email a copy of the Health Net Orange Option 2 (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $90.10 | ||||
Annual Deductible: | $0 | ||||
$0 Premium if LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. | ||||
Annual Initial Coverage Limit (ICL): | $2,840 | ||||
Additional Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 4,850 drugs | Browse the Health Net Orange Option 2 (PDP) 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: | $2.00 | $34.00 | $68.00 | 33% | 33% |
• Number of Drugs per Tier: | 1438 | 641 | 1798 | 668 | 305 |
Plan Type (Reach): | Regional Plan | ||||
Number of Members enrolled in this plan in North Carolina: | 253 members (CMS Region 08) | ||||
Number of Members enrolled in this plan nationally: | 20,963 members |