2013 / 2014 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 | Total Formulary Drugs | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2013 MedicareBlue Rx Standard (PDP) | $39.60 | $160 | No additional gap coverage, only the Donut Hole Discount | No | S5743 -001 | $4.00 | $18.00 | $40.00 | 48% | 2905 2013 Formulary | ||
2014 MedicareBlue Rx Standard (PDP) | $41.90 | $160 | No additional gap coverage, only the Donut Hole Discount | No | $4.00 | $18.00 | $38.00 | 48% | 2839 2014 Formulary | |||
2013 MedicareBlue Rx Premier (PDP) | $107.00 | $0 | All Generics | No | S5743 -004 | $4.00 | $12.00 | $40.00 | 48% | 2905 2013 Formulary | ||
2014 MedicareBlue Rx Premier (PDP) | $106.30 | $0 | Many Generics | No | $3.00 | $8.00 | $35.00 | 45% | 2839 2014 Formulary | |||
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