2012 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Community CCRx Basic (PDP) by Community CCRx PDP | ||||
State: | Idaho | ||||
Plan ID: | S5803 - 100 - 0 Click to see other plans | ||||
Member Services: | 1-866-684-5353 TTY users 1-866-684-5351 | ||||
— 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 |
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Email a copy of the Community CCRx Basic (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $38.20 | ||||
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: | 3,019 drugs | Browse the Community CCRx Basic (PDP) Formulary | |||
This plan has 4 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 | 25% | 46% | 25% | |
• Number of Drugs per Tier: | 1399 | 779 | 521 | 320 | |
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in your CMS Region: | 10,307 members (CMS Region 31) | ||||
Number of Members enrolled in this plan nationally: | 1,748,882 members | ||||
Plan’s Summary Star Rating: | 3 out of 5 Stars. | ||||
• Customer Service Rating: | 3 out of 5 Stars. | ||||
• Member Experience Rating: | 4 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 3 out of 5 Stars. |