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 - S5768-103 Benefit Details ![]() |
$17.90 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $47.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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SilverScript Value - S5601-042 Benefit Details ![]() |
$24.00 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $28.25 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 | ||||||
AdvantraRx Value - S5670-111 Benefit Details ![]() |
$24.60 | $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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Medco Medicare Prescription Plan - Value - S5660-123 Benefit Details ![]() |
$24.70 | $295 | No Gap Coverage | Yes | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
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HealthSpring Prescription Drug Plan-Reg 21 - S5932-020 Benefit Details ![]() |
$25.60 | $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 | ||||||
Prescriba Rx Bronze - S5597-255 Benefit Details ![]() |
$26.80 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
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Community CCRx Basic - S5803-090 Benefit Details ![]() |
$27.00 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 50% | 3,285 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-127 Sanctioned Plan ![]() |
$27.00 | $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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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 - S5644-196 Benefit Details ![]() |
$27.40 | $295 | No Gap Coverage | Yes | Preferred Generic: $5.00 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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BravoRx - S5998-026 Benefit Details ![]() |
$27.60 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
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CIGNA Medicare Rx Plan One - S5617-103 Benefit Details ![]() |
$28.40 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $28.00 Tier 3: $71.00 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 | ||||||
First Health Part D-Premier - S5768-044 Benefit Details ![]() |
$28.50 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $27.00 Non-Preferred Generic/Non-Preferred Brand: $52.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
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WellCare Classic - S5967-158 Sanctioned Plan ![]() |
$28.50 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $32.00 Tier 3: $83.00 Tier 4: 25% | 2,718 Browse Formulary | ||
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Health Net Orange Option 1 - S5678-048 Benefit Details ![]() |
$30.00 | $295 | No Gap Coverage | No | Preferred Generic: $2.00 Preferred Brand: $41.00 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 | ||||||
Aetna Medicare Rx Essentials - S5810-055 Benefit Details ![]() |
$30.70 | $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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EnvisionRxPlus Silver - S7694-021 Benefit Details ![]() |
$30.70 | $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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MedicareRx Rewards Value - S5960-021 Sanctioned Plan ![]() |
$31.70 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $8.00 Tier 2 Preferred Brand: $41.00 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 | ||||||
Medco Medicare Prescription Plan - Choice - S5660-021 Benefit Details ![]() |
$32.10 | $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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Advantage Freedom Plan by RxAmerica - S5644-182 Benefit Details ![]() |
$34.80 | $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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AARP MedicareRx Saver - S5921-331 Benefit Details ![]() |
$34.90 | $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): $49.45 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 | ||||||
WellCare Signature - S5967-055 Sanctioned Plan ![]() |
$35.40 | $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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SierraRx Basic - S5917-023 Benefit Details ![]() |
$37.30 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 Browse Formulary | ||
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AARP MedicareRx Preferred - S5820-020 Benefit Details ![]() |
$37.50 | $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): $66.25 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 | ||||||
UA Medicare Part D Rx Covg - Silver Plan - S5755-059 Benefit Details ![]() |
$38.30 | $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 - S5617-105 Benefit Details ![]() |
$39.80 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $36.00 Tier 4: $80.00 Tier 5: 33% | 4,053 Browse Formulary | ||
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Sterling Rx - S4802-012 Benefit Details ![]() |
$39.80 | $295 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Brand: $58.00 Specialty: 25% | 5,234 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 | ||||||
Health Net Value Orange Option 2 - S5678-047 Benefit Details ![]() |
$40.30 | $0 | No Gap Coverage | No | Preferred Generic: $0.00 Preferred Brand: $39.00 Non-Preferred Brand: $75.00 Injectable: 33% Specialty: 33% | 4,743 Browse Formulary | ||
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Prescriba Rx Gold - S5597-053 Benefit Details ![]() |
$40.50 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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AdvantraRx Premier - S5670-112 Benefit Details ![]() |
$41.50 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $69.00 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 | ||||||
Humana PDP Standard S5884-079 - S5884-079 Benefit Details ![]() |
$43.70 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 45% | 4,828 Browse Formulary | ||
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UA Medicare Part D Prescription Drug Cov - S5755-024 Benefit Details ![]() |
$44.50 | $0 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $33.00 Non-Preferred Brand: $66.00 Specialty: 33% | 3,607 Browse Formulary | ||
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Community CCRx Choice - S5803-158 Benefit Details ![]() |
$44.80 | $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 | ||||||
Humana PDP Enhanced S5884-019 - S5884-019 Benefit Details ![]() |
$45.10 | $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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RxBLUE - S5937-001 Benefit Details ![]() |
$45.30 | $0 | No Gap Coverage | No | Generic: $8.00 Preferred Brand: $32.00 Non-Preferred Brand: $73.00 Specialty: 33% | 5,168 Browse Formulary | ||
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UnitedHealth Rx Basic - S5921-332 Benefit Details ![]() |
$47.20 | $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): $86.00 Tier 4 - Specialty (Generic, Brand): 33% | 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 | ||||||
EnvisionRxPlus Gold - S7694-055 Benefit Details ![]() |
$47.60 | $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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AdvantraRx Premier Plus - S5670-114 Benefit Details ![]() |
$55.90 | $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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Aetna Medicare Rx Plus - S5810-157 Benefit Details ![]() |
$59.70 | $0 | Some Generics | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $10.00 Tier 3 - Preferred Brand: $36.00 Tier 4 - Non-Preferred Brand: $76.00 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 Plus - S5601-043 Benefit Details ![]() |
$59.80 | $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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Community CCRx Gold - S5803-238 Benefit Details ![]() |
$63.80 | $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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Medco Medicare Prescription Plan - Access - S5660-191 Benefit Details ![]() |
$69.10 | $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 | ||||||
CIGNA Medicare Rx Plan Three - S5617-191 Benefit Details ![]() |
$69.90 | $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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Prescriba Rx Platinum - S5597-218 Benefit Details ![]() |
$71.40 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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AARP MedicareRx Enhanced - S5921-333 Benefit Details ![]() |
$73.60 | $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): $82.00 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 | ||||||
SilverScript Complete - S5601-092 Benefit Details ![]() |
$79.90 | $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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Aetna Medicare Rx Premier - S5810-191 Benefit Details ![]() |
$92.10 | $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 S5884-049 - S5884-049 Benefit Details ![]() |
$93.60 | $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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