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) (S4802-147) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$15.50 | $415 | 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% | 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) (S5601-024) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $15.00 Preferred Brand: $44.00 Non-Preferred Drug: 47% 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) (S5601-024) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $15.00 Preferred Brand: $44.00 Non-Preferred Drug: 47% Specialty Tier: 33% | 167,957 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-158) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.80 | $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% | 76,869 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Preferred (PDP) (S5820-011) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$71.00 | $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% | 73,820 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-106) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.20 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 38% Specialty Tier: 25% | 59,739 Browse Formulary | |||
Express Scripts Medicare - Value (PDP) (S5660-114) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$30.20 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $25.00 Non-Preferred Drug: 41% Specialty Tier: 25% | 55,567 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 Value Script (PDP) (S4802-147) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$15.50 | $415 | 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% | 3,337 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Aetna Medicare Rx Select (PDP) (S5810-286) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.10 | $365 | 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) (S5617-291) 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: ![]() | ||||||||
Express Scripts Medicare - Saver (PDP) (S5660-228) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$24.50 | $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: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-393) 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: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-158) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.80 | $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: ![]() | ||||||||
Mutual of Omaha Rx Value (PDP) (S7126-044) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.80 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 15% Non-Preferred Drug: 35% Specialty Tier: 25% | 2,810 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Aetna Medicare Rx Saver (PDP) (S5810-046) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.10 | $295 | 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: 27% | 3,291 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-106) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.20 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 38% Specialty Tier: 25% | 2,992 Browse Formulary | |||
SilverScript Choice (PDP) (S5601-024) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $15.00 Preferred Brand: $44.00 Non-Preferred Drug: 47% Specialty Tier: 33% | 3,005 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
WellCare Classic (PDP) (S4802-071) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.90 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: $37.00 Non-Preferred Drug: 42% Specialty Tier: 25% | 2,999 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() |