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) (S4802-158) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$15.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $6.00 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) (S5601-050) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$32.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Drug: 43% 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) (S5601-050) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$32.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Drug: 43% Specialty Tier: 33% | 231,288 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-171) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$25.60 | $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% | 208,341 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
MedicareBlue Rx Standard (PDP) (S5743-001) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$37.90 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $7.00 Preferred Brand: 16% Non-Preferred Drug: 35% Specialty Tier: 25% | 207,636 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-145) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$31.80 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 39% Specialty Tier: 25% | 94,643 Browse Formulary | |||
Aetna Medicare Rx Saver (PDP) (S5810-059) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$32.40 | $310 | 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% | 78,984 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) (S4802-158) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$15.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $6.00 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) (S5810-302) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.40 | $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) (S5617-304) 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: ![]() | ||||||||
Journey Rx Value (PDP) (S6986-013) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$22.70 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 15% Non-Preferred Drug: 35% Specialty Tier: 25% | 3,016 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Express Scripts Medicare - Saver (PDP) (S5660-241) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$25.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: 18% Non-Preferred Drug: 30% Specialty Tier: 25% | 2,810 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-171) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$25.60 | $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: ![]() | ||||||||
Journey Rx Standard (PDP) (S6986-007) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $6.00 Preferred Brand: 15% Non-Preferred Drug: 32% Specialty Tier: 25% | 2,929 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-406) 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: ![]() |