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 -- | S5601 -110 | |||||||||||
2013 SilverScript Choice (PDP) | $29.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 CVS Caremark Value (PDP) | $40.50 | $320 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -002 | $8.00 | $45.00 | $95.00 | 25% | 1,987 members | ||
2013 SilverScript Basic (PDP) | $33.50 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | $2.00 | 22% | 43% | 33% | tbd members | |||
2012 CVS Caremark Plus (PDP) | $79.00 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -003 | $0.00 | $40.00 | $90.00 | 33% | 465 members | ||
2013 SilverScript Plus (PDP) | $91.30 | $0 | Many Generics, Some Brands |
No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 Health Net Orange Option 1 (PDP) | $39.10 | $320 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -014 | $4.00 | $43.00 | $92.00 | 25% | 243 members | ||
-- Members will be assigned to SilverScript Basic S5601-002 -- | ||||||||||||
2012 Community CCRx Basic (PDP) | $27.20 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5803 -070 | $2.00 | 25% | 47% | 25% | 8,612 members | ||
-- Members will be assigned to SilverScript Basic S5601-002 -- | ||||||||||||
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 Health Net Value Orange Option 2 (PDP) | $67.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -013 | $0.00 | $32.00 | $64.00 | 33% | 698 members | ||
-- Members will be assigned to SilverScript Plus S5601-003 -- | ||||||||||||
2012 Community CCRx Choice (PDP) | $90.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5803 -138 | $0.00 | $40.00 | $70.00 | 33% | 341 members | ||
-- Members will be assigned to SilverScript Plus S5601-003 -- | ||||||||||||
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