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 - S5768-099 Benefit Details ![]() |
$16.20 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $49.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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AARP MedicareRx Saver - S5921-081 Benefit Details ![]() |
$24.90 | $295 | No Gap Coverage | Yes | Tier 1 - Preferred Generic: $5.00 Tier 2 - Generic and Preferred Brand: $22.00 Tier 3 - Other Non Preferred (Generic, Brand): $63.05 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 | ||||||
AdvantraRx Value - S5670-087 Benefit Details ![]() |
$25.50 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Preferred Brand: $24.00 Non-Preferred Generic/Non-Preferred Brand: $55.00 Specialty-Generic and Brand: 33% | 3,149 Browse Formulary | ||
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Prescriba Rx Bronze - S5597-251 Benefit Details ![]() |
$27.30 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
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SilverScript Value - S5601-034 Benefit Details ![]() |
$27.80 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $33.50 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 | ||||||
UnitedHealth Rx Basic - S5921-082 Benefit Details ![]() |
$27.90 | $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): $64.00 Tier 4 - Specialty (Generic, Brand): 33% | 4,548 Browse Formulary | ||
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First Health Part D-Premier - S5768-042 Benefit Details ![]() |
$28.50 | $0 | No Gap Coverage | Yes | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $61.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
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Health Net Orange Option 1 - S5678-040 Benefit Details ![]() |
$28.60 | $295 | No Gap Coverage | Yes | Preferred Generic: $2.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Injectable: 25% Specialty: 25% | 4,743 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 Star Plan by RxAmerica - S5644-192 Benefit Details ![]() |
$28.90 | $295 | No Gap Coverage | Yes | Preferred Generic: $6.25 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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Community CCRx Basic - S5803-086 Benefit Details ![]() |
$29.20 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 60% | 3,285 Browse Formulary | ||
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BravoRx - S5998-038 Benefit Details ![]() |
$29.50 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 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 | ||||||
Medco Medicare Prescription Plan - Value - S5660-119 Benefit Details ![]() |
$29.60 | $295 | No Gap Coverage | Yes | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-123 Sanctioned Plan ![]() |
$29.60 | $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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HealthSpring Prescription Drug Plan-Reg 17 - S5932-016 Benefit Details ![]() |
$29.80 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,420 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 One - S5617-083 Benefit Details ![]() |
$30.20 | $295 | No Gap Coverage | Yes | Tier 1: $2.50 Tier 2: $33.00 Tier 3: $80.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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Blue Medicare Rx - Value - S5715-001 Benefit Details ![]() |
$30.50 | $0 | No Gap Coverage | No | Generic: $9.00 Preferred Brand: $44.00 Brand: $73.00 Specialty: 30% | 3,061 Browse Formulary | ||
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EnvisionRxPlus Silver - S7694-017 Benefit Details ![]() |
$30.50 | $295 | No Gap Coverage | No | Tier 1 Preferred Generic: $4.00 Tier 2 Non Preferred Generics: $32.00 Tier 3 Preferred Brand: $22.00 Tier 4 NonPreferred Brand: $75.00 Tier 5 Specialty Drugs: 25% | 2,654 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 Essentials - S5810-051 Benefit Details ![]() |
$31.30 | $190 | No Gap Coverage | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $29.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: 25% | 5,374 Browse Formulary | ||
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Medco Medicare Prescription Plan - Choice - S5660-017 Benefit Details ![]() |
$33.10 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
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MedicareRx Rewards Value - S5960-017 Sanctioned Plan ![]() |
$33.70 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $8.50 Tier 2 Preferred Brand: $44.50 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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
WellCare Classic - S5967-154 Sanctioned Plan ![]() |
$33.70 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $33.00 Tier 3: $85.00 Tier 4: 25% | 2,718 Browse Formulary | ||
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AARP MedicareRx Preferred - S5820-016 Benefit Details ![]() |
$34.50 | $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): $80.40 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
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WellCare Signature - S5967-051 Sanctioned Plan ![]() |
$35.20 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Gold - S5597-049 Benefit Details ![]() |
$36.20 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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Blue Medicare Rx - Standard - S5715-007 Benefit Details ![]() |
$37.90 | $295 | No Gap Coverage | No | Generic: $2.00 Preferred Brand: $33.00 Brand: $63.00 Specialty: 25% | 3,061 Browse Formulary | ||
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Humana PDP Standard S5884-075 - S5884-075 Benefit Details ![]() |
$39.00 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 43% | 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 - S4802-028 Benefit Details ![]() |
$39.60 | $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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AdvantraRx Premier - S5670-088 Benefit Details ![]() |
$42.70 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $26.00 Non-Preferred Generic/Non-Preferred Brand: $75.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
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CIGNA Medicare Rx Plan Two - S5617-085 Benefit Details ![]() |
$43.80 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $38.00 Tier 4: $80.00 Tier 5: 33% | 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 | ||||||
Humana PDP Enhanced S5884-015 - S5884-015 Benefit Details ![]() |
$44.30 | $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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UA Medicare Part D Rx Covg - Silver Plan - S5755-055 Benefit Details ![]() |
$44.30 | $125 | 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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Community CCRx Choice - S5803-154 Benefit Details ![]() |
$49.10 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
SilverScript Plus - S5601-035 Benefit Details ![]() |
$50.10 | $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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UA Medicare Part D Prescription Drug Cov - S5755-020 Benefit Details ![]() |
$50.10 | $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 2 - S5678-039 Benefit Details ![]() |
$53.00 | $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 | ||||||
AdvantraRx Premier Plus - S5670-090 Benefit Details ![]() |
$57.30 | $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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Advantage Freedom Plan by RxAmerica - S5644-178 Benefit Details ![]() |
$58.10 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: 35% Specialty: 33% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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Aetna Medicare Rx - Costco Plus Plan - S5810-153 Benefit Details ![]() |
$59.30 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
SilverScript Complete - S5601-088 Benefit Details ![]() |
$65.10 | $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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EnvisionRxPlus Gold - S7694-051 Benefit Details ![]() |
$67.90 | $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 - S5917-019 Benefit Details ![]() |
$68.50 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 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 Three - S5617-187 Benefit Details ![]() |
$69.10 | $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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AARP MedicareRx Enhanced - S5921-083 Benefit Details ![]() |
$70.70 | $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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Medco Medicare Prescription Plan - Access - S5660-187 Benefit Details ![]() |
$71.20 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Platinum - S5597-214 Benefit Details ![]() |
$71.90 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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Community CCRx Gold - S5803-234 Benefit Details ![]() |
$73.00 | $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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Blue Medicare Rx - Plus - S5715-002 Benefit Details ![]() |
$77.50 | $0 | All Generics | No | Generic: $5.00 Preferred Brand: $38.00 Brand: $60.00 Specialty: 30% | 3,061 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 | ||||||
Humana PDP Complete S5884-045 - S5884-045 Benefit Details ![]() |
$101.10 | $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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Aetna Medicare Rx Premier - S5810-187 Benefit Details ![]() |
$103.30 | $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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