Click on the Benefits & Contact Info button for more plan details
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance 30-Day Supply | Total Formulary Drugs | |||
---|---|---|---|---|---|---|---|---|
SilverScript SmartRx (PDP) (S5601-205) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$6.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 25% | 3,564 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
WellCare Medicare Rx Value Plus (PDP) (S5768-153) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$71.90 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: 48% Specialty Tier: 33% select insulin pay $35 copay | 3,476 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance |
State Members | |||
---|---|---|---|---|---|---|---|---|
SilverScript Choice (PDP) (S5601-060) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$31.30 | $260 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Drug: 43% Specialty Tier: 28% | 96,588 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Preferred (PDP) (S5820-029) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$92.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Drug: 40% Specialty Tier: 33% | 58,396 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Saver Plus (PDP) (S5921-374) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$32.20 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $6.00 Preferred Brand: $32.00 Non-Preferred Drug: 40% Specialty Tier: 25% | 50,007 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Premier Rx Plan (PDP) (S5884-176) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$65.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: 49% Specialty Tier: 25% | 47,894 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-209) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.20 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 18% Non-Preferred Drug: 35% Specialty Tier: 25% | 45,921 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
SilverScript SmartRx (PDP) (S5601-205) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$6.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 25% | 3,564 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Premier Rx (PDP) (S6946-054) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$14.00 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $40.00 Non-Preferred Drug: 45% Specialty Tier: 25% | 3,276 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Elixir RxPlus (PDP) (S7694-136) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$14.30 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $6.00 Preferred Brand: $43.00 Non-Preferred Drug: 45% Specialty Tier: 25% | 3,243 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
WellCare Wellness Rx (PDP) (S4802-199) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.20 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Drug: 46% Specialty Tier: 25% select insulin pay $35 copay | 3,466 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-209) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.20 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 18% Non-Preferred Drug: 35% Specialty Tier: 25% | 3,175 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
WellCare Value Script (PDP) (S4802-135) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$18.70 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $43.00 Non-Preferred Drug: 47% Specialty Tier: 25% select insulin pay $35 copay | 3,466 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna Secure-Essential Rx (PDP) (S5617-309) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$24.00 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $2.00 Preferred Brand: 18% Non-Preferred Drug: 50% Specialty Tier: 25% | 3,140 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
WellCare Medicare Rx Select (PDP) (S5810-306) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$24.50 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $47.00 Non-Preferred Drug: 42% Specialty Tier: 25% | 3,466 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Mutual of Omaha Rx Premier (PDP) (S7126-099) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$24.90 | $445 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $2.00 Preferred Brand: 23% Non-Preferred Drug: 41% Specialty Tier: 25% select insulin pay $25 copay | 2,943 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Express Scripts Medicare - Saver (PDP) (S5660-246) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.50 | $285 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: $35.00 Non-Preferred Drug: 50% Specialty Tier: 28% select insulin pay $35 copay | 2,951 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
A few notes to help with the understanding of the 2021 Medicare Part D Plan chart above.
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, we cannot guarantee the accuracy of this information. Through the application process we will provide you with the most up-to-the-minute information/pricing. |