Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community


2012 Medicare Part D and Medicare Advantage Plan Formulary Browser

Select your search style and criteria below or use this example to get started

Search by:
State & Plan   ZIP & Plan   PlanID   FormularyID

Search Criteria
PDP     MAPD
Scroll down to see formulary results.

EnvisionRxPlus Silver (PDP) (S7694-032-0)
Tier 1 (556)
Tier 2 (1128)
Tier 3 (355)
Tier 4 (327)
Tier 5 (252)
Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either
  *required
 
Cick on the first letter of your drug name to browse the 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 
2012 Medicare Part D Plan Formulary Information
EnvisionRxPlus Silver (PDP) (S7694-032-0)
Benefit Details           
The EnvisionRxPlus Silver (PDP) (S7694-032-0)
Formulary Drugs Starting with the Letter L

in CMS PDP Region 32 which includes: CA
Drugs Starting with Letter L

Drug Name
Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
L1 PROTEIN, HUMAN PAPILLOMAVIRUS TYPE 16 VACCINE 0.04 MG/ML / L1 PROTEIN, HUMAN PAPILLOMAVIRU   4 Non-Preferred Brand Drugs 25%N/ANone
L1 PROTEIN, HUMAN PAPILLOMAVIRUS TYPE 16 VACCINE 0.04 MG/ML / L1 PROTEIN, HUMAN PAPILLOMAVIRUS TYPE   4 Non-Preferred Brand Drugs 25%N/ANone
LABETALOL HCL 100MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LABETALOL HCL 200MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LABETALOL HCL 300MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LABETALOL HCL 5MG/20ML VIAL   1 Preferred Generic Drugs 25%N/ANone
LACLOTION 12% LOTION   2 Non-Preferred Generic Drugs 25%N/ANone
LACRISERT OPTHALMIC INSERT 5MG 60 BLPK   4 Non-Preferred Brand Drugs 25%N/ANone
LACTATED RINGERS INJECTION   1 Preferred Generic Drugs 25%N/ANone
LACTATED RINGERS IRRIGATION 20-30-600MG 3000ML BAG   1 Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LACTULOSE SOLUTION ORAL 10GM/15ML 946ML BOT   1 Preferred Generic Drugs 25%N/ANone
LAMIVUDINE 150 MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LAMIVUDINE 300 MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LAMIVUDINE-ZIDOVUDINE TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LAMOTRIGINE 150MG TABLET (60 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LAMOTRIGINE 200MG TABLET (60 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LAMOTRIGINE 25MG TABLET (100 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LAMOTRIGINE 25MG TABLET DISPERSIBLE   2 Non-Preferred Generic Drugs 25%N/ANone
LAMOTRIGINE 5MG TABLET DISPERSIBLE   2 Non-Preferred Generic Drugs 25%N/ANone
LAMOTRIGINE TABLET 100MG (100 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LANREOTIDE 240 MG/ML PREFILLED SYRINGE [SOMATULINE]   5 Specialty Tier Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LANTUS 100U/ML VIAL   3 Preferred Brand Drugs 25%N/ANone
LANTUS SOLOSTAR INJECTION   3 Preferred Brand Drugs 25%N/ANone
LATANOPROST OPHTHALMIC SOLUTION .005%   2 Non-Preferred Generic Drugs 25%N/ANone
LATUDA 20 MG TABLET   4 Non-Preferred Brand Drugs 25%N/ANone
Latuda 40mg/1   4 Non-Preferred Brand Drugs 25%N/ANone
Latuda 80mg/1   4 Non-Preferred Brand Drugs 25%N/ANone
LEFLUNOMIDE 10MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LEFLUNOMIDE TABLETS   2 Non-Preferred Generic Drugs 25%N/ANone
LETAIRIS 10MG TABLET   5 Specialty Tier Drugs 25%N/ANone
LETAIRIS 5MG TABLET   5 Specialty Tier Drugs 25%N/ANone
Letrozole 2.5mg/1 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC   2 Non-Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LEUCOVORIN CALCIUM 100MG VL   2 Non-Preferred Generic Drugs 25%N/ANone
LEUCOVORIN CALCIUM 10MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
Leucovorin Calcium 15mg/1 24 TABLET in 1 BOTTLE   2 Non-Preferred Generic Drugs 25%N/ANone
LEUCOVORIN CALCIUM 25MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LEUCOVORIN CALCIUM 350MG VL   2 Non-Preferred Generic Drugs 25%N/ANone
LEUCOVORIN CALCIUM 5MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LEUKERAN 2MG TABLET   3 Preferred Brand Drugs 25%N/ANone
LEUKINE INJECTION 250 MCG/ML   5 Specialty Tier Drugs 25%N/ANone
LEUPROLIDE ACETATE INJECTION   2 Non-Preferred Generic Drugs 25%N/ANone
LEVEMIR 100UNITS/ML VIAL   3 Preferred Brand Drugs 25%N/ANone
Levemir 14.2mg/mL 5 SYRINGE, PLASTIC in 1 CARTON / 3 mL in 1 SYRINGE, PLASTIC   3 Preferred Brand Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LEVETIRACETAM 100 MG/ML SOLN 100MG/ML 16 FL OZ BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM 500 MG TABLET 120 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM ER 500 MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM ER 750 MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM INJECTION   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM TABLETS 1000MG 60 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM TABLETS 250MG 500 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LEVETIRACETAM TABLETS 750MG 500 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LEVOBUNOLOL 0.25% EYE DROPS   1 Preferred Generic Drugs 25%N/ANone
LEVOBUNOLOL HYDROCHLORIDE OPHTHALMIC SOLUTION   1 Preferred Generic Drugs 25%N/ANone
LEVOCARNITINE 100MG/ML SOLUTION ORAL   1 Preferred Generic Drugs 25%N/AP
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LEVOCARNITINE 200MG/ML VIAL   1 Preferred Generic Drugs 25%N/AP
LEVOCARNITINE TABLET 330MG 90 BLPK   2 Non-Preferred Generic Drugs 25%N/AP
Levofloxacin 250mg/1   2 Non-Preferred Generic Drugs 25%N/ANone
Levofloxacin 25mg/mL 1 BOTTLE in 1 CARTON / 100 mL in 1 BOTTLE   2 Non-Preferred Generic Drugs 25%N/ANone
Levofloxacin 25mg/mL 1 VIAL in 1 CARTON / 30 mL in 1 VIAL   2 Non-Preferred Generic Drugs 25%N/ANone
Levofloxacin 500mg/1   2 Non-Preferred Generic Drugs 25%N/ANone
Levofloxacin 5mg/mL 24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 100 mL in 1 BAG   2 Non-Preferred Generic Drugs 25%N/ANone
Levofloxacin 750mg/1   2 Non-Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM .075MG TABLET (1000 CT)   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM .150MG TABLET (100 CT)   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 100MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LEVOTHYROXINE SODIUM 112MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 125MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 137MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 175MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 200MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 25MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 300MCG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 50MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEVOTHYROXINE SODIUM 88MCG TABLET   1 Preferred Generic Drugs 25%N/ANone
LEXIVA 50mg/mL 225 mL in 1 BOTTLE   4 Non-Preferred Brand Drugs 25%N/ANone
LEXIVA TABLETS   5 Specialty Tier Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LIDOCAINE 5% OINTMENT   2 Non-Preferred Generic Drugs 25%N/ANone
LIDOCAINE HCL 0.5% VIAL   1 Preferred Generic Drugs 25%N/ANone
LIDOCAINE HCL 1% VIAL   2 Non-Preferred Generic Drugs 25%N/ANone
LIDOCAINE HCL 2% JELLY 30ML TUBE   2 Non-Preferred Generic Drugs 25%N/ANone
LIDOCAINE HCL TOPICAL SOLUTION 4% 50ML BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LIDOCAINE-PRILOCAINE 2.5%-2.5% CREAM   2 Non-Preferred Generic Drugs 25%N/ANone
LIDODERM 5% PATCH   4 Non-Preferred Brand Drugs 25%N/ANone
LINCOCIN 300MG/ML VIAL   4 Non-Preferred Brand Drugs 25%N/ANone
Lindane 10mg/mL   2 Non-Preferred Generic Drugs 25%N/ANone
LINDANE SHAMPOO 1MG 2 FLO BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LIOTHYRONINE SODIUM TABLETS 25MCG 100 TABLETS BOT   2 Non-Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LIOTHYRONINE SODIUM TABLETS 50MCG 100 TABLETS BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LIOTHYRONINE SODIUM TABLETS 5MCG 100 TABLETS BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LIPOFEN CAPSULES   3 Preferred Brand Drugs 25%N/ANone
LISINOPRIL 10MG TABLET (100 CT)   1 Preferred Generic Drugs 25%N/ANone
Lisinopril 2.5mg 100 TABLET BOTTLE   1 Preferred Generic Drugs 25%N/ANone
LISINOPRIL 20MG TABLET   1 Preferred Generic Drugs 25%N/ANone
LISINOPRIL 30MG TABLET (100 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LISINOPRIL 40MG TABLET (500 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
Lisinopril 5mg/1 1000 TABLET in 1 BOTTLE   1 Preferred Generic Drugs 25%N/ANone
LISINOPRIL-HCTZ 10/12.5 TABLET   1 Preferred Generic Drugs 25%N/ANone
LISINOPRIL-HCTZ 20-25MG TABLET (100 CT)   1 Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LISINOPRIL-HCTZ 20/12.5 TABLET   1 Preferred Generic Drugs 25%N/ANone
LITHIUM CARBONATE 150MG CAPSULE   2 Non-Preferred Generic Drugs 25%N/ANone
LITHIUM CARBONATE 300MG CAPSULE (100 CT)   1 Preferred Generic Drugs 25%N/ANone
LITHIUM CARBONATE 300MG TABLET   2 Non-Preferred Generic Drugs 25%N/ANone
Lithium Carbonate 450mg/1   2 Non-Preferred Generic Drugs 25%N/ANone
LITHIUM CARBONATE CAPSULES   2 Non-Preferred Generic Drugs 25%N/ANone
LITHIUM CARBONATE ER TABLET 300MG (100 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LITHIUM CIT 8MEQ/5ML SYRUP   1 Preferred Generic Drugs 25%N/ANone
LOKARA 0.05% LOTION   2 Non-Preferred Generic Drugs 25%N/ANone
LOPERAMIDE HCL 2MG CAPSULE   2 Non-Preferred Generic Drugs 25%N/ANone
LOSARTAN POTASSIUM 100 MG TAB   2 Non-Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LOSARTAN POTASSIUM 25 MG TAB   2 Non-Preferred Generic Drugs 25%N/ANone
LOSARTAN POTASSIUM 50 MG TAB   2 Non-Preferred Generic Drugs 25%N/ANone
LOSARTAN-HCTZ 100-12.5 MG TAB   2 Non-Preferred Generic Drugs 25%N/ANone
LOSARTAN-HCTZ 100-25 MG TAB   2 Non-Preferred Generic Drugs 25%N/ANone
LOSARTAN-HCTZ 50-12.5 MG TAB   2 Non-Preferred Generic Drugs 25%N/ANone
LOTRONEX TABLETS .5MG 30 BOTPL   3 Preferred Brand Drugs 25%N/ANone
LOTRONEX TABLETS 1MG 30 BOTPL   3 Preferred Brand Drugs 25%N/ANone
LOVAZA 1g/ 120 LIQUID FILLED CAPSULES in BOTTLE   3 Preferred Brand Drugs 25%N/ANone
LOXAPINE 25MG CAPSULE (100 CT)   2 Non-Preferred Generic Drugs 25%N/ANone
LOXAPINE CAPSULES 10MG 100 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LOXAPINE CAPSULES 50MG 100 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LOXAPINE CAPSULES 5MG 100 BOT   2 Non-Preferred Generic Drugs 25%N/ANone
LUMIGAN 0.03% EYE DROPS   3 Preferred Brand Drugs 25%N/ANone
LUMIGAN 0.1mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 5 mL in 1 BOTTLE, DROPPER   3 Preferred Brand Drugs 25%N/ANone
Lupron Depot 1 KIT in 1 CARTON   5 Specialty Tier Drugs 25%N/ANone
LUPRON DEPOT 11.25 MG 3MO KIT   4 Non-Preferred Brand Drugs 25%N/ANone
LUPRON DEPOT 22.5 MG 3MO KIT [LUPRON]   4 Non-Preferred Brand Drugs 25%N/ANone
LUPRON DEPOT 3.75 MG KIT   3 Preferred Brand Drugs 25%N/ANone
LUPRON DEPOT 7.5 MG KIT   4 Non-Preferred Brand Drugs 25%N/ANone
LUPRON DEPOT-4 MONTH KIT   3 Preferred Brand Drugs 25%N/ANone
LUPRON DEPOT-PED 11.25 MG KIT   3 Preferred Brand Drugs 25%N/ANone
LUPRON DEPOT-PED 15 MG KIT   3 Preferred Brand Drugs 25%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
LYRICA 100MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 150MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 200MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 225MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 25MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 300MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 50MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYRICA 75MG CAPSULE   3 Preferred Brand Drugs 25%N/ANone
LYSODREN 500MG TABLET   3 Preferred Brand Drugs 25%N/ANone
LYSTEDA TABLETS   3 Preferred Brand Drugs 25%N/ANone

Chart Legend:

Below are a few notes to help you understand the above 2012 Medicare Part D EnvisionRxPlus Silver (PDP) Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region).

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the standard $320 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.

    • No - This plan does not qualify for the $0 Premium for persons with the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.
  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have four (4) tiers 1=Preferred Generics, 2=Preferred Brands, 3=Non-preferred Brands and Generics, 4=Specialty Drugs.
    • Drug Description - This is the Medicare Part D plan’s description of this particular drug tier.
  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $2930) at a "Preferred" network pharmacy. In most cases, the "Preferred" network and network pharmacy pricing are the same. However, for example on the 2012 Humana Walmart-Preferred Rx Plan the cost-sharing is much higher at a network pharmacy over a "Preferred" network pharmacy. "Preferred" network pharmacies for this plan include only Walmart, Sam’s Club and RightSource.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).
  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.




(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2012 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.





 
 

Medicare Supplements
fill the gaps in your
Original Medicare
1. Enter Your ZIP Code:
» Medicare Supplement FAQs





Pets are Family Too!
Use your drug discount card to save on medications for the entire family ‐ including your pets.

  • No enrollment fee and no limits on usage
  • Everyone in your household can use the same card, including your pets
Your drug discount card is available to you at no cost.




Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.