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2014 Medicare Prescription Drug Plan Benefit Details for the EmblemHealth Medicare Prescription Drug Plan (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2014 Medicare Prescription Drug Plan Details
Medicare Plan Name:EmblemHealth Medicare Prescription Drug Plan (PDP)
   by EmblemHealth Medicare PDP
State:New York
Plan ID:S5966 - 001 - 0     Click to see other plans
Member Services:1-800-585-5786
— 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 EmblemHealth Medicare Prescription Drug Plan (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$50.00
Annual Deductible:$310
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,850
Drug Benefit Type ❔Actuarially Equivalent Standard (AE)
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,224 drugsBrowse the EmblemHealth Medicare Prescription Drug Plan (PDP) Formulary
This plan has 4 drug tiers. See cost-sharing for all pharmacies and tiers. 
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$4.0025%25%25% 
• Number of Drugs per
  Tier:		2151849846314
Plan Offers Mail Order?Yes
Plan Type (Reach):Regional Plan
Number of Members enrolled in this plan in New York:5,457 members     (CMS Region 03)
Number of Members enrolled in this plan nationally:5,457 members
Plan’s Summary Star Rating: 5 out of 5 Stars.  
This plan qualifies for the 5-star rating Special Enrollment period. Read more.
• Customer Service Rating: 4 out of 5 Stars.
• Member Experience Rating: 4 out of 5 Stars.
• Drug Cost Accuracy Rating: 4 out of 5 Stars.




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