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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) (S5601-185) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$7.30 | $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 | 3,695 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 Plus (PDP) (S5601-021) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$69.60 | $0 | Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 33% select insulin pay $35 copay | 3,638 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) (S5601-020) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$32.50 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: 17% Non-Preferred Drug: 39% Specialty Tier: 25% | 85,436 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-145) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$11.10 | $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 | 65,441 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
SilverScript SmartSaver (PDP) (S5601-185) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$7.30 | $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% | 43,591 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Humana Basic Rx Plan (PDP) (S5884-135) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$35.80 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 7% Generic: 11% Preferred Brand: 20% Non-Preferred Drug: 35% Specialty Tier: 25% | 36,805 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Preferred (PDP) (S5820-009) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$118.00 | $0 | Yes, some additional gap coverage. | Preferred Generic: $7.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 33% | 36,532 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) (S5601-185) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$7.30 | $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 | 3,695 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Wellcare Value Script (PDP) (S4802-145) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$11.10 | $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 | 3,454 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Cigna Saver Rx (PDP) (S5617-360) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$12.80 | $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 | 3,350 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Premier Rx (PDP) (S6946-036) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$19.60 | $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 | 3,207 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Mutual of Omaha Rx Essential (PDP) (S7126-112) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$20.40 | $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 | 3,189 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
Clear Spring Health Value Rx (PDP) (S6946-007) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$26.20 | $505 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: $42.00 Non-Preferred Drug: 34% Specialty Tier: 25% select insulin coverage $35 or less | 3,157 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: ![]() | ||||||||
AARP MedicareRx Walgreens (PDP) (S5921-392) Benefits & Contact Info ![]() ![]() ![]() ![]() |
$28.30 | $350 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: 45% Specialty Tier: 27% select insulin coverage $35 or less | 3,307 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. |