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2012 Medicare Prescription Drug Plan Cost-Sharing Details

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2012 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
AARP MedicareRx Preferred (PDP) (S5820-031-0)
Benefit Details        
This plan is available in CMS PDP Region 32
Click on a letter below to view the
AARP MedicareRx Preferred (PDP) Formulary
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  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order* Preferred Pharmacy Standard Pharmacy Mail- Order*
This plan does not have an Initial Deductible:n/an/an/an/an/an/a
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic Drugs: $4.00 $4.00 n/a $12.00 $12.00 $0.00
Tier 2: Non-Preferred Generic Drugs: $8.00 $8.00 n/a $24.00 $24.00 $8.00
Tier 3: Preferred Brand Drugs: $43.00 $43.00 n/a $129.00 $129.00 $114.00
Tier 4: Non-Preferred Brand Drugs: $94.00 $94.00 n/a $282.00 $282.00 $267.00
Tier 5: Specialty Tier Drugs: 33% 33% n/a 33% 33% 33%
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 14% Generic and 50% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 86% 86% 86% 86% 86% 86%
All Formulary Brand-Name Drugs: 50% 50% 50% 50% 50% 50%
Catastrophic Coverage Phase Cost Sharing
Generic & Preferred Multi-Source Drugs: The greater of 5% or $2.60 The greater of 5% or $2.60
Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): The greater of 5% or $6.50 The greater of 5% or $6.50
Go to the AARP MedicareRx Preferred (PDP) 2012 Formulary Browser by choosing a letter below:
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