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2016 Medicare Prescription Drug Plan Cost-Sharing Details

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2016 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
AARP MedicareRx Preferred (PDP) (S5820-002-0)
Benefit Details        
This plan is available in CMS PDP Region 2
which includes: CT MA RI VT

Monthly Premium: $55.40
Rx Deductible: $0
Initial Coverage Limit: $3,310 Qualifies for LIS: No


Click on a letter below to view the
AARP MedicareRx Preferred (PDP) Formulary
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This Plan Uses Lower Cost-Sharing for Preferred Pharmacies
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order* Preferred Pharmacy Standard Pharmacy Mail- Order*
This plan does not have an Initial Deductible:n/an/an/an/an/an/a
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic: $2.00 $4.00 n/a $6.00 $12.00 $0.00
Tier 2: Generic: $10.00 $20.00 n/a $30.00 $60.00 $0.00
Tier 3: Preferred Brand: $36.00 $46.00 n/a $108.00 $138.00 $93.00
Tier 4: Non-Preferred Brand: 40% 50% n/a 40% 50% 40%
Tier 5: Specialty Tier: 33% 33% n/a 33% 33% 33%
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 42% Generic and 55% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 58% 58% 58% 58% 58% 58%
All Formulary Brand-Name Drugs: 45% 45% 45% 45% 45% 45%
Catastrophic Coverage Phase Cost Sharing
Generic & Preferred Multi-Source Drugs: The greater of 5% or $2.95 The greater of 5% or $2.95
Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): The greater of 5% or $7.40 The greater of 5% or $7.40
Go to the AARP MedicareRx Preferred (PDP) 2016 Formulary Browser by choosing a letter below:
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