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Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance 30-Day Supply | Total Formulary Drugs | |||
---|---|---|---|---|---|---|---|---|
SilverScript SmartSaver (PDP) (S5601-195) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$4.70 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $15.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% select insulin pay $20 copay | 3,641 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) (S4802-223) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$71.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Diabetic Drugs: $11.00 select insulin pay $35 copay | 3,425 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) (S5601-040) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: 17% Non-Preferred Drug: 35% Specialty Tier: 25% | 53,302 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-154) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$11.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $44.00 Non-Preferred Drug: 47% Specialty Tier: 25% Select Diabetic Drugs: $11.00 | 29,809 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Classic (PDP) (S4802-074) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.70 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $36.00 Non-Preferred Drug: 39% Specialty Tier: 25% | 24,878 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Basic Rx Plan (PDP) (S5884-142) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$31.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 19% Non-Preferred Drug: 38% Specialty Tier: 25% | 19,478 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-199) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$30.60 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $2.00 Preferred Brand: 16% Non-Preferred Drug: 37% Specialty Tier: 25% | 18,710 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 SmartSaver (PDP) (S5601-195) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$4.70 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $15.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% select insulin pay $20 copay | 3,641 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-154) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$11.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $44.00 Non-Preferred Drug: 47% Specialty Tier: 25% Select Diabetic Drugs: $11.00 select insulin pay $35 copay | 3,414 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna Saver Rx (PDP) (S5617-370) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$12.50 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: 50% Specialty Tier: 25% select insulin coverage $35 or less | 3,295 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Premier Rx (PDP) (S6946-046) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.60 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 45% Specialty Tier: 25% select insulin pay $35 copay | 3,174 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Mutual of Omaha Rx Essential (PDP) (S7126-122) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$19.30 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: 20% Non-Preferred Drug: 48% Specialty Tier: 25% select insulin coverage $35 or less | 3,132 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Value Rx (PDP) (S6946-017) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$25.50 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $42.00 Non-Preferred Drug: 36% Specialty Tier: 25% select insulin coverage $35 or less | 3,129 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Elixir RxPlus (PDP) (S7694-134) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.80 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $6.00 Preferred Brand: $43.00 Non-Preferred Drug: 47% Specialty Tier: 25% select insulin coverage $35 or less | 3,081 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna Secure Rx (PDP) (S5617-226) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $5.00 Preferred Brand: $28.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00 select insulin coverage $35 or less | 3,168 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Classic (PDP) (S4802-074) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.70 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $36.00 Non-Preferred Drug: 39% Specialty Tier: 25% select insulin coverage $35 or less | 3,057 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript Choice (PDP) (S5601-040) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: 17% Non-Preferred Drug: 35% Specialty Tier: 25% select insulin coverage $35 or less | 3,486 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Elixir RxSecure (PDP) (S7694-020) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.80 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 15% Non-Preferred Drug: 33% Specialty Tier: 25% select insulin coverage $35 or less | 2,996 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |
A few notes to help with the understanding of the 2023 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. |