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2021 Medicare Prescription Drug Plan Benefit Details for the Cigna Secure-Extra Rx (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2021 Medicare Prescription Drug Plan Details
Medicare Plan Name:Cigna Secure-Extra Rx (PDP)
   by Cigna
State:Arizona
Plan ID:S5617 - 273 - 0     Click to see other plans
Member Services:1-800-222-6700 TTY users 711
— 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 Cigna Secure-Extra Rx (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$52.40 (see Plan Premium Details below)
Annual Deductible:$100 (Tier 1, 2 and 3 excluded from the Deductible.)
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium. (See premiums for partial LIS subsidy below.)
Annual Initial Coverage Limit (ICL):$4,130
Drug Benefit Type ❔Enhanced Alternative (EA)
Additional Gap Coverage?Yes, some additional gap coverage.
Total Number of Formulary Drugs:3,331 drugsBrowse the Cigna Secure-Extra Rx (PDP) Formulary
This plan has 6 drug tiers. See cost-sharing for all pharmacies and tiers. 
This plan offers select insulin at a $11 copay. Learn more.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$4.00$10.00$42.0050%31%
• Number of Drugs per
  Tier:		1768345871183525
Plan Offers Mail Order?Yes
Medicare Plan Pharmacy Numbers: BIN: 017010   PCN: CIMCARE   See BIN/PCNs for all plans
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in Arizona:3,290 members     (CMS Region 28)
Number of Members enrolled in this plan nationally:159,937 members
Plan’s Summary Star Rating: 3.5 out of 5 Stars.
• Customer Service Rating: 3 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 Basic
Premium		Part D Supplemental
Premium
$52.40$-2.60$55.00
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔100%
Subsidy		75%
Subsidy		50%
Subsidy		25%
Subsidy
Monthly Part D Premium with LIS:$52.40$52.40$52.40$52.40




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