2014 Medicare Prescription Drug Plan Details | |||||
---|---|---|---|---|---|
Medicare Plan Name: | MedicareRx Rewards Standard (PDP) by UniCare | ||||
State: | Nebraska | ||||
Plan ID: | S5960 - 131 - 0 Click to see other plans | ||||
Member Services: | 1-800-928-6201 TTY users 1-877-247-1657 | ||||
— 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 MedicareRx Rewards Standard (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $59.30 | ||||
Annual Deductible: | $310 | ||||
$0 Premium if Full LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. | ||||
Annual Initial Coverage Limit (ICL): | $2,850 | ||||
Additional Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 2,578 drugs | Browse the MedicareRx Rewards Standard (PDP) Formulary | |||
This plan has 6 drug tiers. See cost-sharing for all pharmacies and tiers. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $1.00 | $2.00 | $24.00 | $76.00 | $95.00 |
• Number of Drugs per Tier: | 300 | 858 | 582 | 263 | 227 |
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in your CMS Region: | 1,596 members (CMS Region 25) | ||||
Number of Members enrolled in this plan nationally: | 40,152 members | ||||
Plan’s Summary Star Rating: | 2.5 out of 5 Stars. | ||||
• Customer Service Rating: | 5 out of 5 Stars. | ||||
• Member Experience Rating: | 3 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 2 out of 5 Stars. |