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 - S5768-095 Benefit Details ![]() |
$14.80 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $48.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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AdvantraRx Value - S5670-069 Benefit Details ![]() |
$22.50 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Preferred Brand: $23.00 Non-Preferred Generic/Non-Preferred Brand: $50.00 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 | ||||||
AARP MedicareRx Saver - S5921-161 Benefit Details ![]() |
$25.40 | $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): $66.95 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
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SilverScript Value - S5601-026 Benefit Details ![]() |
$28.90 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $39.00 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
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First Health Part D-Premier - S5768-016 Benefit Details ![]() |
$29.40 | $0 | No Gap Coverage | Yes | Preferred Generic: $7.00 Preferred Brand: $27.00 Non-Preferred Generic/Non-Preferred Brand: $54.00 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 | ||||||
Prescriba Rx Bronze - S5597-247 Benefit Details ![]() |
$29.40 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-119 Sanctioned Plan ![]() |
$30.00 | $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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HealthSpring Prescription Drug Plan-Reg 13 - S5932-012 Benefit Details ![]() |
$30.10 | $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 | ||||||
Community CCRx Basic - S5803-082 Benefit Details ![]() |
$30.20 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 60% | 3,285 Browse Formulary | ||
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Advantage Star Plan by RxAmerica - S5644-078 Benefit Details ![]() |
$30.50 | $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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BravoRx - S5998-009 Benefit Details ![]() |
$30.90 | $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 | ||||||
Aetna Medicare Rx Essentials - S5810-047 Benefit Details ![]() |
$31.80 | $200 | No Gap Coverage | Yes | 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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WellCare Classic - S5967-150 Sanctioned Plan ![]() |
$31.80 | $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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EnvisionRxPlus Silver - S7694-013 Benefit Details ![]() |
$32.80 | $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 | ||||||
CIGNA Medicare Rx Plan One - S5617-063 Benefit Details ![]() |
$32.90 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $33.00 Tier 3: $88.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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Medco Medicare Prescription Plan - Value - S5660-115 Benefit Details ![]() |
$33.30 | $295 | No Gap Coverage | No | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
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Health Net Orange Option 1 - S5678-032 Benefit Details ![]() |
$33.60 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
MedicareRx Rewards Value - S5960-013 Sanctioned Plan ![]() |
$34.10 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $46.00 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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Alliance Medicare RX - S3440-001 Benefit Details ![]() |
$35.00 | $0 | No Gap Coverage | No | Tier 1: $8.00 Tier 2: $40.00 Tier 3: $60.00 Tier 4: $60.00 | 3,546 Browse Formulary | ||
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UA Medicare Part D Rx Covg - Silver Plan - S5755-051 Benefit Details ![]() |
$37.40 | $160 | 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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Sterling Rx - S4802-025 Benefit Details ![]() |
$38.00 | $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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Medco Medicare Prescription Plan - Choice - S5660-013 Benefit Details ![]() |
$38.40 | $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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PriorityMedicareRx - S5857-001 Benefit Details ![]() |
$38.40 | $0 | No Gap Coverage | No | Generic Drugs: $7.00 Preferred Brand on Formulary: $42.00 Non-Preferred Brand: $65.00 Specialty Tier: 33% | 2,994 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 - S5967-047 Sanctioned Plan ![]() |
$38.70 | $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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Humana PDP Enhanced S5884-011 - S5884-011 Benefit Details ![]() |
$38.90 | $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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AdvantraRx Premier - S5670-070 Benefit Details ![]() |
$39.10 | $0 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $76.00 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 | ||||||
AARP MedicareRx Preferred - S5820-012 Benefit Details ![]() |
$39.30 | $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): $94.10 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
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CIGNA Medicare Rx Plan Two - S5617-065 Benefit Details ![]() |
$39.40 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $43.00 Tier 4: $85.00 Tier 5: 33% | 4,053 Browse Formulary | ||
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Humana PDP Standard S5884-071 - S5884-071 Benefit Details ![]() |
$40.40 | $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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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 - S5644-057 Benefit Details ![]() |
$40.60 | $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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UnitedHealth Rx Basic - S5921-162 Benefit Details ![]() |
$40.60 | $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): $98.00 Tier 4 - Specialty (Generic, Brand): 33% | 4,548 Browse Formulary | ||
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Prescriba Rx Gold - S5597-045 Benefit Details ![]() |
$40.80 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 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 | ||||||
UA Medicare Part D Prescription Drug Cov - S5755-016 Benefit Details ![]() |
$42.60 | $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 - S5601-027 Benefit Details ![]() |
$44.10 | $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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Health Net Value Orange Option 2 - S5678-031 Benefit Details ![]() |
$44.80 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescription Blue Option A - S5584-001 Benefit Details ![]() |
$47.50 | $50 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $30.00 Non Preferred: $55.00 Specialty: 25% Non Self Administered Injectable: 25% | 5,367 Browse Formulary | ||
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Community CCRx Choice - S5803-150 Benefit Details ![]() |
$48.80 | $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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Alliance Medicare RX - S3440-003 Benefit Details ![]() |
$50.00 | $150 | No Gap Coverage | No | Tier 1: $3.00 Tier 2: $17.00 Tier 3: $55.00 Tier 4: $55.00 | 3,546 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 | ||||||
Prescription Blue Option B - S5584-002 Benefit Details ![]() |
$50.00 | $0 | Many Generics | No | Generic: $7.00 Preferred Brand: $30.00 Non Preferred: $55.00 Specialty: 25% Non Self Administered Injectable: 25% | 5,367 Browse Formulary | ||
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AdvantraRx Premier Plus - S5670-072 Benefit Details ![]() |
$53.60 | $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 - Costco Plus Plan - S5810-149 Benefit Details ![]() |
$56.00 | $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 - S5601-084 Benefit Details ![]() |
$63.10 | $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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Alliance Medicare RX - S3440-002 Benefit Details ![]() |
$64.00 | $0 | All Generics, Few Brands |
No | Tier 1: $2.00 Tier 2: $35.00 Tier 3: $55.00 Tier 4: $55.00 | 3,546 Browse Formulary | ||
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Community CCRx Gold - S5803-230 Benefit Details ![]() |
$67.70 | $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 | ||||||
Medco Medicare Prescription Plan - Access - S5660-183 Benefit Details ![]() |
$67.90 | $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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EnvisionRxPlus Gold - S7694-047 Benefit Details ![]() |
$68.90 | $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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AARP MedicareRx Enhanced - S5921-163 Benefit Details ![]() |
$75.20 | $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 | ||||||
CIGNA Medicare Rx Plan Three - S5617-183 Benefit Details ![]() |
$76.20 | $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 - S5597-210 Benefit Details ![]() |
$77.00 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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Humana PDP Complete S5884-041 - S5884-041 Benefit Details ![]() |
$97.80 | $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 - S5810-183 Benefit Details ![]() |
$106.00 | $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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