2020 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Cigna-HealthSpring Rx Secure-Extra (PDP) by Cigna | ||||
State: | Utah | ||||
Plan ID: | S5617 - 276 - 0 Click to see other plans | ||||
Member Services: | 1-800-222-6700 | ||||
— 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 |
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Email a copy of the Cigna-HealthSpring Rx Secure-Extra (PDP) benefit details
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— Medicare Plan Features — | |||||
Monthly Premium: | $56.30 (see Plan Premium Details below) | ||||
Annual Deductible: | $100 (Tier 1, 2, 3 and 6 excluded from the Deductible.) | ||||
$0 Premium if Full LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. (See premiums for partial LIS subsidy below.) | ||||
Annual Initial Coverage Limit (ICL): | $4,020 | ||||
Additional Gap Coverage? | Yes, some additional gap coverage. | ||||
Total Number of Formulary Drugs: | 3,389 drugs | Browse the Cigna-HealthSpring Rx Secure-Extra (PDP) Formulary | |||
This plan has 6 drug tiers.
See cost-sharing for all pharmacies and tiers.
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Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $4.00 | $10.00 | $42.00 | 49% | 31% |
• Number of Drugs per Tier: | 169 | 838 | 541 | 1327 | 491 |
Plan Offers Mail Order? | Yes | ||||
Medicare Plan Pharmacy Numbers: | BIN: 017010 PCN: CIHSCARE See BIN/PCNs for all plans | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in Utah: | 1,688 members | ||||
Number of Members enrolled in this plan in your CMS Region: | 3,307 members (CMS Region 31) | ||||
Number of Members enrolled in this plan nationally: | 156,685 members | ||||
Plan’s Summary Star Rating: | 3.5 out of 5 Stars. | ||||
• Customer Service Rating: | 4 out of 5 Stars. | ||||
• Member Experience Rating: | 5 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 3 out of 5 Stars. | ||||
— Plan Premium Details — | |||||
The Monthly Premium is Split as Follows: ❔ | Total Premium | Part D Base Premium | Part D Supplemental Premium | ||
$56.30 | $46.20 | $10.10 | |||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ | 100% Subsidy | 75% Subsidy | 50% Subsidy | 25% Subsidy | |
Monthly Part D Premium with LIS: | $19.50 | $28.70 | $37.90 | $47.10 |