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 | |||
---|---|---|---|---|---|---|---|---|
WellCare Value Script (PDP) (S4802-151) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$14.50 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $43.00 Non-Preferred Drug: 47% Specialty Tier: 25% | 3,337 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 Choice (PDP) (S5601-034) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $9.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 33% | 3,005 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) (S5601-034) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $9.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 33% | 173,460 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Preferred (PDP) (S5820-016) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$69.20 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: 40% Specialty Tier: 33% | 111,618 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Blue Cross MedicareRx Value (PDP) (S5715-001) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$70.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $42.00 Non-Preferred Brand: 40% Specialty Tier: 25% | 107,915 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-163) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$23.50 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 20% Non-Preferred Drug: 35% Specialty Tier: 25% | 87,493 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-107) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.20 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 40% Specialty Tier: 25% | 66,650 Browse Formulary | |||
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
WellCare Value Script (PDP) (S4802-151) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$14.50 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $43.00 Non-Preferred Drug: 47% Specialty Tier: 25% | 3,337 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Aetna Medicare Rx Select (PDP) (S5810-291) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$16.20 | $390 | Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $2.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 25% | 3,743 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna-HealthSpring Rx Secure-Essential (PDP) (S5617-296) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$21.90 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: 20% Non-Preferred Drug: 49% Specialty Tier: 25% | 3,161 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-163) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$23.50 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 20% Non-Preferred Drug: 35% Specialty Tier: 25% | 3,071 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Express Scripts Medicare - Saver (PDP) (S5660-233) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$24.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 18% Non-Preferred Drug: 32% Specialty Tier: 25% | 2,810 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Aetna Medicare Rx Saver (PDP) (S5810-051) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$24.10 | $345 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $2.00 Preferred Brand: $30.00 Non-Preferred Drug: 35% Specialty Tier: 26% | 3,291 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna-HealthSpring Rx Secure (PDP) (S5617-224) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$25.50 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $30.00 Non-Preferred Drug: 36% Specialty Tier: 25% | 3,195 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Saver Plus (PDP) (S5921-362) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.10 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $8.00 Preferred Brand: $25.00 Non-Preferred Drug: 33% Specialty Tier: 25% | 2,964 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-107) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.20 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 40% Specialty Tier: 25% | 2,992 Browse Formulary | |||
SilverScript Choice (PDP) (S5601-034) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $9.00 Generic: $19.00 Preferred Brand: $46.00 Non-Preferred Drug: 49% Specialty Tier: 33% | 3,005 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
EnvisionRxPlus (PDP) (S7694-017) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.90 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: 15% Non-Preferred Drug: 32% Specialty Tier: 25% | 2,997 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
WellCare Classic (PDP) (S4802-087) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $2.00 Preferred Brand: $35.00 Non-Preferred Drug: 39% Specialty Tier: 25% | 2,999 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-398) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.10 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Drug: 32% Specialty Tier: 25% | 2,898 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Mutual of Omaha Rx Value (PDP) (S7126-049) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.10 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 15% Non-Preferred Drug: 36% Specialty Tier: 25% | 2,810 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |