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 CVS Caremark Value (PDP) | $25.80 | $320 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -058 | $5.75 | $45.00 | $95.00 | 25% | 2,051 members | ||
2013 SilverScript Basic (PDP) | $23.10 | $325 | No additional gap coverage, only the Donut Hole Discount | No | $2.00 | 23% | 43% | 33% | tbd members | |||
-- This plan not offered in 2012 -- | S5601 -138 | |||||||||||
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 Plus (PDP) | $82.60 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -059 | $0.00 | $40.00 | $90.00 | 33% | 522 members | ||
2013 SilverScript Plus (PDP) | $110.50 | $0 | Many Generics, Some Brands |
No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 Health Net Orange Option 1 (PDP) | $26.60 | $320 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -062 | $4.00 | $45.00 | $94.00 | 25% | 4,435 members | ||
-- Members will be assigned to SilverScript Basic S5601-058 -- | ||||||||||||
2012 Community CCRx Basic (PDP) | $24.90 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5803 -098 | $2.00 | 25% | 45% | 25% | 8,174 members | ||
-- Members will be assigned to SilverScript Basic S5601-058 -- | ||||||||||||
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) | $75.30 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -061 | $0.00 | $32.00 | $64.00 | 33% | 289 members | ||
-- Members will be assigned to SilverScript Plus S5601-059 -- | ||||||||||||
2012 Community CCRx Choice (PDP) | $84.30 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5803 -166 | $0.00 | $40.00 | $70.00 | 33% | 321 members | ||
-- Members will be assigned to SilverScript Plus S5601-059 -- | ||||||||||||
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