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 - S5768-097 Benefit Details ![]() |
$16.80 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $45.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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AdvantraRx Value - S5674-026 Benefit Details ![]() |
$24.40 | $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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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 15 - S5932-014 Benefit Details ![]() |
$25.60 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
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SilverScript Value - S5601-030 Benefit Details ![]() |
$28.00 | $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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First Health Part D-Premier - S5768-018 Benefit Details ![]() |
$28.10 | $0 | No Gap Coverage | Yes | Preferred Generic: $6.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $58.00 Specialty-Generic and Brand: 33% | 3,393 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 Saver - S5921-061 Benefit Details ![]() |
$28.20 | $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): $59.65 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
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Medco Medicare Prescription Plan - Value - S5660-117 Benefit Details ![]() |
$28.90 | $295 | No Gap Coverage | Yes | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
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Advantage Freedom Plan by RxAmerica - S5644-176 Benefit Details ![]() |
$29.10 | $0 | No Gap Coverage | No | Preferred Generic: $4.50 Preferred Brand: 35% Specialty: 33% 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 Bronze - S5597-249 Benefit Details ![]() |
$29.80 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
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Advantage Star Plan by RxAmerica - S5644-190 Benefit Details ![]() |
$31.00 | $295 | No Gap Coverage | Yes | Preferred Generic: $5.50 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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Community CCRx Basic - S5803-084 Benefit Details ![]() |
$31.80 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 45% | 3,285 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 - S5998-021 Benefit Details ![]() |
$32.50 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
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CIGNA Medicare Rx Plan One - S5617-073 Benefit Details ![]() |
$33.50 | $295 | No Gap Coverage | Yes | Tier 1: $2.50 Tier 2: $30.00 Tier 3: $79.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-121 Sanctioned Plan ![]() |
$33.70 | $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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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 - S5810-049 Benefit Details ![]() |
$33.90 | $200 | No Gap Coverage | Yes | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $70.00 Tier 5 - Specialty: 25% | 5,374 Browse Formulary | ||
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Health Net Orange Option 1 - S5678-036 Benefit Details ![]() |
$34.80 | $295 | No Gap Coverage | No | 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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WellCare Classic - S5967-152 Sanctioned Plan ![]() |
$34.90 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $31.00 Tier 3: $77.00 Tier 4: 25% | 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 | ||||||
EnvisionRxPlus Silver - S7694-015 Benefit Details ![]() |
$35.00 | $295 | No Gap Coverage | No | Tier 1 Preferred Generic: $4.00 Tier 2 Non Preferred Generics: $31.00 Tier 3 Preferred Brand: $21.00 Tier 4 NonPreferred Brand: $75.00 Tier 5 Specialty Drugs: 25% | 2,654 Browse Formulary | ||
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Medco Medicare Prescription Plan - Choice - S5660-015 Benefit Details ![]() |
$35.10 | $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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Blue MedicareRx Value - S5596-017 Sanctioned Plan ![]() |
$37.70 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $38.00 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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Gold - S5597-047 Benefit Details ![]() |
$38.40 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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WellCare Signature - S5967-049 Sanctioned Plan ![]() |
$38.40 | $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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AdvantraRx Premier - S5674-027 Benefit Details ![]() |
$40.50 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $73.00 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 | ||||||
UA Medicare Part D Rx Covg - Silver Plan - S5755-053 Benefit Details ![]() |
$40.70 | $130 | 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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CIGNA Medicare Rx Plan Two - S5617-075 Benefit Details ![]() |
$41.20 | $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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AARP MedicareRx Preferred - S5820-014 Benefit Details ![]() |
$41.90 | $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): $76.00 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 | ||||||
Humana PDP Standard S5884-073 - S5884-073 Benefit Details ![]() |
$42.10 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 47% | 4,828 Browse Formulary | ||
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Sterling Rx - S4802-009 Benefit Details ![]() |
$42.40 | $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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Community CCRx Choice - S5803-152 Benefit Details ![]() |
$43.40 | $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 | ||||||
UnitedHealth Rx Basic - S5921-062 Benefit Details ![]() |
$44.00 | $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): $89.00 Tier 4 - Specialty (Generic, Brand): 33% | 4,548 Browse Formulary | ||
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Blue MedicareRx Plus - S5596-018 Sanctioned Plan ![]() |
$44.30 | $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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Humana PDP Enhanced S5884-013 - S5884-013 Benefit Details ![]() |
$47.90 | $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 - S5755-018 Benefit Details ![]() |
$48.70 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $31.00 Non-Preferred Brand: $62.00 Specialty: 33% | 3,607 Browse Formulary | ||
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SilverScript Plus - S5601-031 Benefit Details ![]() |
$51.30 | $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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AdvantraRx Premier Plus - S5674-029 Benefit Details ![]() |
$55.50 | $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 | ||||||
Aetna Medicare Rx Plus - S5810-151 Benefit Details ![]() |
$58.80 | $0 | Some Generics | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $10.00 Tier 3 - Preferred Brand: $38.00 Tier 4 - Non-Preferred Brand: $78.00 Tier 5 - Specialty: 33% | 5,374 Browse Formulary | ||
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Health Net Orange Option 2 - S5678-035 Benefit Details ![]() |
$62.00 | $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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SierraRx Basic - S5917-018 Benefit Details ![]() |
$65.70 | $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 - S5617-185 Benefit Details ![]() |
$66.10 | $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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Community CCRx Gold - S5803-232 Benefit Details ![]() |
$66.70 | $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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SilverScript Complete - S5601-086 Benefit Details ![]() |
$66.90 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Platinum - S5597-212 Benefit Details ![]() |
$69.50 | $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 - S5660-185 Benefit Details ![]() |
$71.30 | $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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AARP MedicareRx Enhanced - S5921-063 Benefit Details ![]() |
$71.70 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
EnvisionRxPlus Gold - S7694-049 Benefit Details ![]() |
$72.30 | $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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Blue MedicareRx Premier - S5596-019 Sanctioned Plan ![]() |
$79.10 | $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% | 3,730 Browse Formulary | ||
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Humana PDP Complete S5884-043 - S5884-043 Benefit Details ![]() |
$98.40 | $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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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 - S5810-185 Benefit Details ![]() |
$100.90 | $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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