2025 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Cigna Healthcare Extra Rx (PDP) by Cigna Healthcare | ||||
State: | Louisiana | ||||
Plan ID: | S5617 - 266 - 0 Click to see other plans | ||||
Member Services: | (800)222-6700 TTY users 711 | ||||
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 Healthcare Extra Rx (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $121.60 (see Plan Premium Details below) | ||||
Annual Deductible: | $175 (Tier 1 and 2 excluded from the Deductible.) | ||||
$0 Premium if LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. (See premium for LIS subsidy beneficiaries below.) | ||||
Drug Benefit Type ❔ | Enhanced Alternative (EA) | ||||
Total Number of Formulary Drugs: | 3,377 drugs | Browse the Cigna Healthcare Extra Rx (PDP) Formulary | |||
Formulary Exception Tier: | Tier 4 | If your formulary exception request is approved, your drug will be placed on this tier. | |||
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. | |||||
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $1.00 | $8.00 | 18% | 45% | 31% |
• Number of Drugs per Tier: | 248 | 522 | 840 | 1053 | 714 |
Plan's Pharmacy Search: | http://www.cigna.com/part-d | ||||
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in Louisiana: | 3,277 members (CMS Region 21) | ||||
Number of Members enrolled in this plan nationally: | 236,647 members | ||||
Plan’s Summary Star Rating: | 2.5 out of 5 Stars. | ||||
• Customer Service Rating: | 3 out of 5 Stars. | ||||
• Member Experience Rating: | 2 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 2 out of 5 Stars. | ||||
— Plan Premium Details — | |||||
The Monthly Premium is Split as Follows: ❔ | Total Premium | Part D Basic Premium | Part D Supplemental Premium | ||
$121.60 | $88.40 | $33.20 | |||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ | $66.00 |