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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2012 First Health Part D Value Plus (PDP) | $28.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5768 -144 | $0.00 | 25% | 40% | 33% | 5,027 members | ||
2013 First Health Part D Value Plus (PDP) | $30.70 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $35.00 | $70.00 | 33% | tbd members | |||
-- This plan not offered in 2012 -- | S5768 -159 | |||||||||||
2013 First Health Part D Essentials (PDP) | $39.00 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | $1.15 | 20% | 30% | tbd members | ||||
2012 First Health Part D Premier Plus (PDP) | $102.10 | $0 | Some Generics, Some Brands |
No | S5670 -114 | $0.00 | $20.00 | 25% | 43% | 1,086 members | ||
2013 First Health Part D Premier Plus (PDP) | $100.40 | $0 | Some Generics, Some Brands |
No | $0.00 | $20.00 | 25% | 43% | tbd members | |||
2012 First Health Part D Premier (PDP) | $48.30 | $250 | No additional gap coverage, only the Donut Hole Discount | No | S5768 -044 | $5.00 | 21% | 37% | 26% | 4,807 members | ||
-- Members will be assigned to First Health Part D Essentials S5768-159 -- | ||||||||||||
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