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2012 Medicare Prescription Drug Plan Benefit Details for the CVS Caremark Value (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2012 Medicare Prescription Drug Plan Details
Medicare Plan Name:CVS Caremark Value (PDP)
   by SilverScript Insurance Company
State:Rhode Island
Plan ID:S5601 - 004 - 0     Click to see other plans
Member Services:1-866-235-5660 TTY users 1-866-236-1069
— 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 CVS Caremark Value (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$30.70
Annual Deductible:$320
$0 Premium if LIS Benefits?Yes, this plan does qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,930
Drug Benefit Type ❔Actuarially Equivalent Standard (AE)
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,044 drugsBrowse the CVS Caremark Value (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:		$6.25$45.00$95.0025% 
• Number of Drugs per
  Tier:		187180594274
Plan Offers Mail Order?Yes
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in your CMS Region:109,871 members     (CMS Region 02)
Number of Members enrolled in this plan nationally:1,317,497 members
Plan’s Summary Star Rating: 3 out of 5 Stars.
• Customer Service Rating: 3 out of 5 Stars.
• Member Experience Rating: 2 out of 5 Stars.
• Drug Cost Accuracy Rating: 3 out of 5 Stars.




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