2012 / 2013 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 2012 -- | S5967 -198 | |||||||||||
2013 WellCare Extra (PDP) | $49.00 | $0 | Many Generics | No | $0.00 | 25% | 25% | 50% | tbd members | |||
2012 Rite Aid EnvisionRxPlus (PDP) | $74.30 | $0 | Some Generics | No | S7694 -097 | $0.00 | 20% | 15% | 30% | 34 members | ||
2013 EnvisionRxPlus Gold (PDP) | $54.00 | $150 | Some Generics | No | $2.00 | $5.00 | $25.00 | 30% | tbd members | |||
-- This plan not offered in 2012 -- | S0064 -062 | |||||||||||
2013 SmartD Rx Plus (PDP) | $73.50 | $0 | Some Generics | No | $0.00 | $20.00 | $31.00 | $85.00 | tbd members | |||
2012 Blue MedicareRx Plus (PDP) | $73.40 | $0 | Some Generics | No | S5596 -060 | $2.00 | $7.00 | $45.00 | $90.00 | 2,742 members | ||
2013 Blue MedicareRx Plus (PDP) | $84.40 | $0 | Few Generics | No | $2.00 | $7.00 | $45.00 | $90.00 | tbd members | |||
2012 Medco Medicare Prescription Plan - Choice (PDP) | $79.70 | $150 | Many Generics | No | S5660 -197 | $6.00 | $12.00 | $45.00 | $95.00 | 860 members | ||
2013 Express Scripts Medicare - Choice (PDP) | $98.80 | $200 | Many Generics | No | $8.00 | $45.00 | $95.00 | 28% | tbd members | |||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Plan Members | |||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | ||||||
2012 First Health Part D Premier Plus (PDP) | $105.40 | $0 | Some Generics, Some Brands |
No | S5670 -138 | $0.00 | $20.00 | 25% | 41% | 1,229 members | ||
2013 First Health Part D Premier Plus (PDP) | $102.50 | $0 | Some Generics, Some Brands |
No | $0.00 | $20.00 | 25% | 41% | tbd members | |||
2012 CVS Caremark Plus (PDP) | $79.90 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -055 | $0.00 | $40.00 | $90.00 | 33% | 625 members | ||
2013 SilverScript Plus (PDP) | $110.80 | $0 | Many Generics, Some Brands |
No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 AARP MedicareRx Enhanced (PDP) | $98.80 | $0 | Some Generics | No | S5921 -223 | $4.00 | $7.00 | $40.00 | $76.00 | 1,572 members | ||
2013 AARP MedicareRx Enhanced (PDP) | $111.40 | $0 | Some Generics, Some Brands |
No | $2.00 | $5.00 | $31.00 | $65.00 | tbd members | |||
2012 Aetna Medicare Rx Premier (PDP) | $94.50 | $0 | Many Generics | No | S5810 -197 | $4.00 | $25.00 | $35.00 | $80.00 | 1,049 members | ||
2013 Aetna Medicare Rx Premier (PDP) | $115.50 | $0 | Many Generics, Some Brands |
No | $5.00 | $33.00 | $45.00 | tbd | tbd members | |||
2012 Blue MedicareRx Premier (PDP) | $127.40 | $0 | Many Generics, Some Brands |
No | S5596 -061 | $2.00 | $7.00 | $45.00 | $90.00 | 1,551 members | ||
2013 Blue MedicareRx Premier (PDP) | $125.90 | $0 | Many Generics, Some Brands |
No | $2.00 | $7.00 | $45.00 | $90.00 | tbd members | |||
2012 Health Net Orange Option 1 (PDP) | $41.60 | $320 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -060 | $5.00 | $44.00 | $90.00 | 25% | 580 members | ||
-- Members will be assigned to SilverScript Basic S5601-054 -- | ||||||||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Plan Members | |||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | ||||||
2012 Community CCRx Basic (PDP) | $30.20 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5803 -096 | $2.00 | 25% | 49% | 25% | 28,487 members | ||
-- Members will be assigned to SilverScript Basic S5601-054 -- | ||||||||||||
2012 Health Net Value Orange Option 2 (PDP) | $70.60 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -059 | $0.00 | $32.00 | $64.00 | 33% | 676 members | ||
-- Members will be assigned to SilverScript Plus S5601-055 -- | ||||||||||||
2012 Community CCRx Choice (PDP) | $90.50 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5803 -164 | $0.00 | $40.00 | $70.00 | 33% | 801 members | ||
-- Members will be assigned to SilverScript Plus S5601-055 -- | ||||||||||||
2012 WellCare Signature (PDP) | $65.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5967 -061 | $0.00 | $20.00 | $45.00 | $90.00 | 2,158 members | ||
-- Members will be assigned to WellCare Classic S5967-164 -- | ||||||||||||
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