2011 / 2012 Medicare Part D Plan Information Click here to jump to the Chart Legend | ||||||||||||
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Plan Name | Monthly Premium |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
$0 Prem. with Full LIS? |
Plan ID |
Cost-Sharing | Members In This Plan | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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-- This plan not offered in 2011 -- | S5768 -128 | |||||||||||
2012 First Health Part D Value Plus (PDP) | $23.40 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | 25% | 40% | 33% | tbd members | |||
2011 First Health Part D Premier (PDP) | $36.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Yes | S5768 -008 | $9.00 | 16% | 35% | 29% | 31,494 members | ||
2012 First Health Part D Premier (PDP) | $32.30 | $250 | No additional gap coverage, only the Donut Hole Discount | Yes | $5.00 | 20% | 38% | 26% | tbd members | |||
2011 First Health Part D Premier Plus (PDP) | $85.80 | $0 | Some Generics, Some Brands |
No | S5670 -030 | $0.00 | $25.00 | 30% | 57% | 1,864 members | ||
2012 First Health Part D Premier Plus (PDP) | $96.20 | $0 | Some Generics, Some Brands |
No | $0.00 | $20.00 | 25% | 43% | tbd members | |||
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