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) (S4802-140) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$14.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 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) (S5601-010) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$30.70 | $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) (S5601-010) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$30.70 | $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% | 89,607 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Preferred (PDP) (S5820-004) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$72.40 | $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% | 84,011 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Saver Plus (PDP) (S5921-350) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.30 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Drug: 33% Specialty Tier: 25% | 49,706 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-151) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $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% | 40,220 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Aetna Medicare Rx Saver (PDP) (S5810-039) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.20 | $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% | 35,381 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) (S4802-140) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$14.00 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 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: ![]() | ||||||||
EnvisionRxPlus (PDP) (S7694-005) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$16.50 | $365 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $6.00 Preferred Brand: $32.00 Non-Preferred Drug: 35% Specialty Tier: 25% | 2,973 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Aetna Medicare Rx Select (PDP) (S5810-279) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$17.20 | $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) (S5617-284) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$21.80 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 25% | 3,161 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Express Scripts Medicare - Saver (PDP) (S5660-221) 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: 33% Specialty Tier: 25% | 2,810 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-387) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.00 | $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: ![]() | ||||||||
Aetna Medicare Rx Saver (PDP) (S5810-039) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.20 | $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% | 3,291 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Mutual of Omaha Rx Value (PDP) (S7126-037) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.40 | $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: ![]() | ||||||||
Cigna-HealthSpring Rx Secure (PDP) (S5617-214) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.70 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $30.00 Non-Preferred Drug: 37% Specialty Tier: 25% | 3,195 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Express Scripts Medicare - Value (PDP) (S5660-107) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.20 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $25.00 Non-Preferred Drug: 42% Specialty Tier: 25% | 2,931 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Saver Plus (PDP) (S5921-350) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.30 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $7.00 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: ![]() | ||||||||
Magellan Rx Medicare Basic (PDP) (S4607-003) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $2.00 Preferred Brand: 19% Non-Preferred Drug: 43% Specialty Tier: 25% | 2,975 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Walmart Rx Plan (PDP) (S5884-151) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.60 | $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: ![]() | ||||||||
Humana Preferred Rx Plan (PDP) (S5884-103) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$29.70 | $415 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 37% Specialty Tier: 25% | 2,992 Browse Formulary | |||