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This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2014 Aetna CVS/pharmacy Prescription Drug Plan (PDP)

Medicare Prescription Drug Plan Benefit Details in Plain Text
The following Medicare Prescription Drug plan (PDP) benefits apply to the Aetna CVS/pharmacy Prescription Drug Plan (PDP) (S5810 - 043) in CMS Region 9, which includes all counties in SC.

This plan is administered by AETNA LIFE INSURANCE COMPANY, a national plan provider. This means that the insurance carrier offers Medicare Part D plan in most every state. To switch to a different Medicare Prescription Drug plan or to change your location, click here.
Click here to see the Aetna CVS/pharmacy Prescription Drug Plan (PDP) prescription drug benefit details in chart format or email and view benefits chart

Plan Premium
The Aetna CVS/pharmacy Prescription Drug Plan (PDP) has a monthly premium of $37.40. That is $448.80 for 12 months. There are a few factors that can increase or decrease this premium. If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA).

Plan Membership and Plan Ratings
The Aetna CVS/pharmacy Prescription Drug Plan (PDP) (S5810 - 043) in CMS Region 9 currently has 3,364 members, and 532,733 members in the Aetna CVS/pharmacy Prescription Drug Plan (PDP) nationwide.

The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3 stars. The detail CMS plan carrier ratings are as follows:
  • Customer Service Rating of 5 out of 5 stars
  • Member Experience Rating of 4 out of 5 stars
  • Drug Cost Information Accuracy Rating of 3 out of 5 stars
Prescription Drug Coverage: Deductible, Cost-sharing, Formulary
This plan has a $310 deductible. So, you are 100% responsible for the first $310 in medication costs. After you have met the deductible, the Aetna CVS/pharmacy Prescription Drug Plan (PDP) will share the costs of your medications with you -- see cost-sharing below. $310 is the maximum deductible for 2014. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible.

The following information is about the Aetna CVS/pharmacy Prescription Drug Plan (PDP) formulary (or drug list). There are 3136 drugs on the Aetna CVS/pharmacy Prescription Drug Plan (PDP) formulary.

The Aetna CVS/pharmacy Prescription Drug Plan (PDP) does offer a mail order service.

Click here to browse the Aetna CVS/pharmacy Prescription Drug Plan (PDP) Formulary.
 
The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $310, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The Aetna CVS/pharmacy Prescription Drug Plan (PDP)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows:
  • Tier 1 (Generic) contains 1,555 drugs and has a co-payment of $2.00.
  • Tier 2 (Preferred Brand) contains 521 drugs and has a co-payment of $45.00.
  • Tier 3 (Non-Preferred Brand) contains 655 drugs and has a co-payment of $95.00.
  • Tier 4 (Specialty Tier) contains 357 drugs and has a co-insurance of 25% of the drug cost.
  • Tier 5 (Select Care Drugs) contains 48 drugs and has a co-payment of $1.00.
    •  
Click here to browse the Aetna CVS/pharmacy Prescription Drug Plan (PDP) Formulary.

The Aetna CVS/pharmacy Prescription Drug Plan (PDP)’s Initial Coverage Limit is $2,850. When this limit is reached, you exit the Initial Coverage Phase and enter the Coverage Gap (or Donut Hole).

The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 28% of your generic drug prescription costs in the donut hole on your behalf.

The brand-name drug manufacturer will pay 50% and your plan will pay an additional 2.5% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 52.5% discount. The 50% paid by the brand-name drug manufacturer is paid on your behalf and therefore counts toward your TrOOP (or True Out-of-Pocket) costs. The portion paid by your plan, does not count toward TrOOP. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage". This plan (Aetna CVS/pharmacy Prescription Drug Plan (PDP)) offers No Coverage during the Coverage Gap phase.





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