Q1GROUP LLC | Q1Medicare.com - a non-government resource for the Medicare community
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2021 Medicare Prescription Drug Plan Cost-Sharing Details

Send this chart to my email
Receive our free Part D Newsletter
2021 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
Elixir RxSecure (PDP) (S7694-032-0)
Benefit Details        
This plan is available in CMS PDP Region 32
Monthly Premium: $30.80
Rx Deductible: $445
Initial Coverage Limit: $4,130 Qualifies for LIS: Yes


Click on a letter below to view the
Elixir RxSecure (PDP) Formulary
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
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*
Initial Deductible Phase Cost Sharing
All Formulary Drug Tiers: 100% 100% 100% 100% 100% 100%
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic: $1.00 $18.00 $1.00 $3.00 $54.00 $0.00
Tier 2: Generic: $7.00 $19.00 $7.00 $21.00 $57.00 $10.50
Tier 3: Preferred Brand: 15% 20% 15% 15% 20% 15%
Tier 4: Non-Preferred Drug: 29% 33% 29% 29% 33% 29%
Tier 5: Specialty Tier: 25% 25% 25% n/a n/a n/a
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 75% Generic and 75% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 25% 25% 25% 25% 25% 25%
All Formulary Brand-Name Drugs: 25% 25% 25% 25% 25% 25%
Catastrophic Coverage Phase Cost Sharing
Generic & Preferred Multi-Source Drugs: The greater of 5% or $3.70 The greater of 5% or $3.70
Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): The greater of 5% or $9.20 The greater of 5% or $9.20
Go to the Elixir RxSecure (PDP) 2021 Formulary Browser by choosing a letter below:
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
Send this chart to my email
Receive our free Part D Newsletter