2009 Medicare Part D Plan Information Click here to jump to the Chart Legend & Search Tips | ||||||||
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Plan Name | Monthly Prem. |
Deduct- ible |
(Donut Hole) Gap Coverage |
$0 Prem. with Full LIS? |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
Total Formulary Drugs | ||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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First Health Part D-Secure - S5768-109 Benefit Details ![]() |
$18.40 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $22.00 Non-Preferred Generic/Non-Preferred Brand: $50.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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Fox Value Plan - S5557-028 Benefit Details ![]() |
$24.90 | $295 | No Gap Coverage | Yes | Tier 1: $0.00 Tier 2: $27.00 Tier 3: $34.00 Tier 4: $75.00 Tier 5: 25% | 3,132 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
HealthSpring Prescription Drug Plan-Reg 27 - S5932-026 Benefit Details ![]() |
$25.80 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
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AdvantraRx Value - S5670-135 Benefit Details ![]() |
$26.00 | $0 | No Gap Coverage | No | Preferred Generic: $9.00 Preferred Brand: $27.00 Non-Preferred Generic/Non-Preferred Brand: $65.00 Specialty-Generic and Brand: 33% | 3,149 Browse Formulary | ||
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Prescriba Rx Bronze - S5597-261 Benefit Details ![]() |
$26.10 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
First Health Part D-Premier - S5768-119 Benefit Details ![]() |
$26.80 | $0 | No Gap Coverage | Yes | Preferred Generic: $7.00 Preferred Brand: $26.00 Non-Preferred Generic/Non-Preferred Brand: $56.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-133 Sanctioned Plan ![]() |
$28.00 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5.: 25% | 41 Browse Formulary | ||
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SilverScript Value - S5601-054 Benefit Details ![]() |
$28.20 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $36.75 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
WellCare Classic - S5967-164 Sanctioned Plan ![]() |
$28.90 | $295 | No Gap Coverage | Yes | Tier 1: $0.00 Tier 2: $32.00 Tier 3: $81.00 Tier 4: 25% | 2,718 Browse Formulary | ||
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SierraRx - S5917-003 Benefit Details ![]() |
$30.00 | $0 | No Gap Coverage | Yes | Generic: $10.00 Brand: $50.00 Specialty: 33% | 2,469 Browse Formulary | ||
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Aetna Medicare Rx Essentials - S5810-061 Benefit Details ![]() |
$30.80 | $200 | No Gap Coverage | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $13.00 Tier 3 - Preferred Brand: $26.00 Tier 4 - Non-Preferred Brand: $67.00 Tier 5 - Specialty: 25% | 5,374 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Blue MedicareRx Value - S5596-025 Sanctioned Plan ![]() |
$31.80 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $45.00 Tier 3 Non-Preferred Brand or Generic: $85.00 Tier 4 Non-Specialty Injectable: 29% Tier 5.: 29% | 3,708 Browse Formulary | ||
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EnvisionRxPlus Silver - S7694-027 Benefit Details ![]() |
$31.90 | $295 | No Gap Coverage | No | Tier 1 Preferred Generic: $4.00 Tier 2 Non Preferred Generics: $30.00 Tier 3 Preferred Brand: $20.00 Tier 4 NonPreferred Brand: $75.00 Tier 5 Specialty Drugs: 25% | 2,654 Browse Formulary | ||
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AARP MedicareRx Saver - S5921-221 Benefit Details ![]() |
$33.00 | $295 | No Gap Coverage | No | Tier 1 - Preferred Generic: $5.00 Tier 2 - Generic and Preferred Brand: $22.00 Tier 3 - Other Non Preferred (Generic, Brand): $68.10 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Community CCRx Basic - S5803-096 Benefit Details ![]() |
$33.10 | $295 | No Gap Coverage | No | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 55% | 3,285 Browse Formulary | ||
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Medco Medicare Prescription Plan - Value - S5660-129 Benefit Details ![]() |
$33.50 | $295 | No Gap Coverage | No | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 52% Specialty: 25% | 3,499 Browse Formulary | ||
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Advantage Star Plan by RxAmerica - S5644-200 Benefit Details ![]() |
$35.10 | $295 | No Gap Coverage | No | Preferred Generic: $5.25 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Gold - S5597-059 Benefit Details ![]() |
$36.10 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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WellCare Signature - S5967-061 Sanctioned Plan ![]() |
$37.20 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $39.00 Tier 3: $79.00 Tier 4: 33% | 2,718 Browse Formulary | ||
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AARP MedicareRx Preferred - S5820-026 Benefit Details ![]() |
$38.50 | $0 | No Gap Coverage | No | Tier 1-Preferred Generic: $7.00 Tier 2 - Generic and Preferred Brand: $38.00 Tier 3 - Other Non Preferred (Generic, Brand): $88.80 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
BravoRx - S5998-031 Benefit Details ![]() |
$38.70 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
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Fox Grand Plan - S5557-019 Benefit Details ![]() |
$39.00 | $265 | Some Generics | No | Tier 1: $0.00 Tier 2: $19.00 Tier 3: $35.00 Tier 4: $75.00 Tier 5: 25% | 3,545 Browse Formulary | ||
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SilverScript Plus - S5601-055 Benefit Details ![]() |
$39.40 | $50 | Many Generics | No | Value Generic: $4.00 Generic: $9.00 Value Brand: $30.00 Preferred Brand: $35.00 Non-Preferred Brand: $95.00 : tbd | 5,320 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Advantage Freedom Plan by RxAmerica - S5644-186 Benefit Details ![]() |
$39.50 | $0 | No Gap Coverage | No | Preferred Generic: $4.75 Preferred Brand: 35% Specialty: 33% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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RMHP Essential Rx - S5860-003 Benefit Details ![]() |
$40.10 | $123 | No Gap Coverage | No | Generic drugs: $9.00 Preferred brand drugs: $40.00 Non-preferred brand drugs: $60.00 Specialty drugs: 30% | 3,823 Browse Formulary | ||
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Humana PDP Standard S5884-085 - S5884-085 Benefit Details ![]() |
$40.90 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 46% | 4,828 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Sterling Rx - S4802-017 Benefit Details ![]() |
$41.60 | $295 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Brand: $57.00 Specialty: 25% | 5,234 Browse Formulary | ||
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UA Medicare Part D Rx Covg - Silver Plan - S5755-065 Benefit Details ![]() |
$42.00 | $140 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 25% | 3,499 Browse Formulary | ||
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Humana PDP Enhanced S5884-025 - S5884-025 Benefit Details ![]() |
$43.30 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
UA Medicare Part D Prescription Drug Cov - S5755-030 Benefit Details ![]() |
$43.60 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $32.00 Non-Preferred Brand: $64.00 Specialty: 33% | 3,607 Browse Formulary | ||
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Health Net Orange Option 1 - S5678-060 Benefit Details ![]() |
$45.30 | $295 | No Gap Coverage | No | Preferred Generic: $2.00 Preferred Brand: $43.00 Non-Preferred Brand: $90.00 Injectable: 25% Specialty: 25% | 4,743 Browse Formulary | ||
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Medco Medicare Prescription Plan - Choice - S5660-027 Benefit Details ![]() |
$45.60 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $38.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
UnitedHealth Rx Basic - S5921-222 Benefit Details ![]() |
$45.80 | $0 | No Gap Coverage | No | Tier 1-Preferred Generic: $7.00 Tier 2 - Generic and Preferred Brand: $35.00 Tier 3 - Other Non Preferred (Generic, Brand): $97.00 Tier 4 - Specialty (Generic, Brand): 33% | 4,548 Browse Formulary | ||
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Blue MedicareRx Plus - S5596-026 Sanctioned Plan ![]() |
$47.20 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic: $9.00 Tier 2 Preferred Brand: $35.00 Tier 3 Non-Preferred Brand or Generic: $75.00 Tier 4 Non-Specialty Injectable: 33% Tier 5.: 33% | 3,730 Browse Formulary | ||
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AdvantraRx Premier - S5670-136 Benefit Details ![]() |
$48.30 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $63.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
CIGNA Medicare Rx Plan Two - S5617-135 Benefit Details ![]() |
$48.90 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $44.00 Tier 4: $85.00 Tier 5: 33% | 4,053 Browse Formulary | ||
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SilverScript Complete - S5601-098 Benefit Details ![]() |
$53.60 | $0 | Many Generics | No | Value Generic: $2.50 Generic: $7.50 Preferred Brand: $39.00 Non-Preferred Brand: $98.00 Specialty: 33% | 5,320 Browse Formulary | ||
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CIGNA Medicare Rx Plan One - S5617-133 Benefit Details ![]() |
$53.70 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $33.00 Tier 3: $82.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Community CCRx Choice - S5803-164 Benefit Details ![]() |
$56.50 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
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Aetna Medicare Rx - Costco Plus Plan - S5810-163 Benefit Details ![]() |
$56.80 | $0 | Some Generics | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $5.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - Non-Preferred Brand: $90.00 Tier 5 - Specialty: 33% | 5,374 Browse Formulary | ||
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Health Net Orange Option 2 - S5678-059 Benefit Details ![]() |
$57.40 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $90.00 Injectable: 33% Specialty: 33% | 5,361 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
EnvisionRxPlus Gold - S7694-061 Benefit Details ![]() |
$59.80 | $0 | No Gap Coverage | No | Tier 1 Preferred Generics: $0.00 Tier 2 NonPreferred Generic: $45.00 Tier 3 Preferred Brand: $40.00 Tier 4 NonPreferred Brand: $75.00 Tier 5 Specialty: 33% | 2,940 Browse Formulary | ||
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SierraRx Basic - S5917-028 Benefit Details ![]() |
$62.20 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 Browse Formulary | ||
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AdvantraRx Premier Plus - S5670-138 Benefit Details ![]() |
$62.70 | $0 | Many Generics | No | Preferred Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $75.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Platinum - S5597-224 Benefit Details ![]() |
$67.80 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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Medco Medicare Prescription Plan - Access - S5660-197 Benefit Details ![]() |
$73.50 | $0 | All Generics | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
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Community CCRx Gold - S5803-244 Benefit Details ![]() |
$74.70 | $0 | All Generics | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AARP MedicareRx Enhanced - S5921-223 Benefit Details ![]() |
$81.80 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $7.00 Tier 2 - Generic and Preferred Brand: $39.00 Tier 3 - Other Non Preferred (Generic, Brand): $95.00 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
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Blue MedicareRx Premier - S5596-027 Sanctioned Plan ![]() |
$86.50 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $9.00 Tier 2 Preferred Brand: $35.00 Tier 3 Non-Preferred Brand or Generic: $75.00 Tier 4 Non-Specialty Injectable: 33% Tier 5.: 33% | 5,114 Browse Formulary | ||
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CIGNA Medicare Rx Plan Three - S5617-197 Benefit Details ![]() |
$88.90 | $0 | Some Generics | No | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | 4,386 Browse Formulary | ||
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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Aetna Medicare Rx Premier - S5810-197 Benefit Details ![]() |
$104.20 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $10.00 Tier 3 - Preferred Brand: $30.00 Tier 4 - Non-Preferred Brand: $65.00 Tier 5 - Specialty: 33% | 5,374 Browse Formulary | ||
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Humana PDP Complete S5884-055 - S5884-055 Benefit Details ![]() |
$107.60 | $0 | Many Generics | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
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RMHP Basic Rx - S5860-001 Benefit Details ![]() |
$112.70 | $0 | No Gap Coverage | No | Generic drugs: $8.75 Preferred brand drugs: $39.00 Non-preferred brand drugs: $59.00 Specialty drugs: 33% | 5,033 Browse Formulary | ||
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