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2013 Medicare Prescription Drug Plan Benefit Details for the Aetna Medicare Rx Premier (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2013 Medicare Prescription Drug Plan Details
Medicare Plan Name:Aetna Medicare Rx Premier (PDP)
   by Aetna Medicare
State:New York
Plan ID:S5810 - 239 - 0     Click to see other plans
Member Services:1-877-238-6211 TTY users 1-888-760-4748
— This plan information is for research purposes only. —
Click here to see plans for the current plan year
Medicare Contact Information:Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.
TTY users 1-877-486-2048
or contact your local SHIP for assistance
Email a copy of the Aetna Medicare Rx Premier (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$122.40
Annual Deductible:$0
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,970
Drug Benefit Type ❔Enhanced Alternative (EA)
Additional Gap Coverage?Many Generics,
Some Brands
Total Number of Formulary Drugs:3,364 drugsBrowse the Aetna Medicare Rx Premier (PDP) Formulary
This plan has 5 drug tiers. See cost-sharing highlights below.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$5.00$33.00$45.000%25%
• Number of Drugs per
  Tier:		1422745289595337
Plan Offers Mail Order?Yes
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in New York:940 members     (CMS Region 03)
Number of Members enrolled in this plan nationally:69,064 members
Plan’s Summary Star Rating: 3.5 out of 5 Stars.
• Customer Service Rating: 4 out of 5 Stars.
• Member Experience Rating: 4 out of 5 Stars.
• Drug Cost Accuracy Rating: 3 out of 5 Stars.




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