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 - S5768-108 Benefit Details ![]() |
$10.30 | $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 - S5601-052 Benefit Details ![]() |
$14.50 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $30.75 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 - S5967-163 Sanctioned Plan ![]() |
$15.20 | $295 | No Gap Coverage | Yes | Tier 1: $0.00 Tier 2: $36.00 Tier 3: $88.00 Tier 4: 25% | 2,718 Browse Formulary | ||
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Prescriba Rx Bronze - S5597-260 Benefit Details ![]() |
$18.00 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
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SierraRx UnitedHealth Rx Value - S5917-002 Benefit Details ![]() |
$18.10 | $0 | No Gap Coverage | No | Generic: $8.00 Brand: $45.00 Specialty: 33% | 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 | ||||||
Advantage Star Plan by RxAmerica - S5644-199 Benefit Details ![]() |
$18.70 | $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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Blue Medicare Rx - Value - S5715-003 Benefit Details ![]() |
$18.70 | $0 | No Gap Coverage | Yes | Generic: $10.00 Preferred Brand: $45.00 Brand: $79.00 Specialty: 30% | 3,061 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-132 Sanctioned Plan ![]() |
$18.90 | $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 | ||||||
Community CCRx Basic - S5803-095 Benefit Details ![]() |
$19.00 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 55% | 3,285 Browse Formulary | ||
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AdvantraRx Value - S5674-038 Benefit Details ![]() |
$19.30 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Preferred Brand: $24.00 Non-Preferred Generic/Non-Preferred Brand: $60.00 Specialty-Generic and Brand: 33% | 3,149 Browse Formulary | ||
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First Health Part D-Premier - S5768-048 Benefit Details ![]() |
$20.80 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $29.00 Non-Preferred Generic/Non-Preferred Brand: $59.00 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 | ||||||
Health Net Orange Option 1 - S5678-058 Benefit Details ![]() |
$21.80 | $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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MedicareRx Rewards Value - S5960-026 Sanctioned Plan ![]() |
$22.50 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $9.00 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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EnvisionRxPlus Silver - S7694-026 Benefit Details ![]() |
$22.90 | $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: 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 | ||||||
AARP MedicareRx Saver - S5921-261 Benefit Details ![]() |
$24.80 | $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): $49.00 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
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HealthSpring Prescription Drug Plan-Reg 26 - S5932-025 Benefit Details ![]() |
$26.20 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
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WellCare Signature - S5967-060 Sanctioned Plan ![]() |
$26.80 | $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 | ||||||
Advantage Freedom Plan by RxAmerica - S5644-185 Benefit Details ![]() |
$27.10 | $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 Essentials - S5810-060 Benefit Details ![]() |
$27.20 | $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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BravoRx - S5998-030 Benefit Details ![]() |
$27.90 | $295 | No Gap Coverage | No | 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 | ||||||
Blue Medicare Rx - Standard - S5715-008 Benefit Details ![]() |
$29.60 | $295 | No Gap Coverage | No | Generic: $2.00 Preferred Brand: $32.00 Brand: $62.00 Specialty: 25% | 3,061 Browse Formulary | ||
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CIGNA Medicare Rx Plan One - S5617-128 Benefit Details ![]() |
$29.70 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $28.00 Tier 3: $60.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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Humana PDP Standard S5884-084 - S5884-084 Benefit Details ![]() |
$30.40 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 50% | 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 | ||||||
Medco Medicare Prescription Plan - Value - S5660-128 Benefit Details ![]() |
$30.40 | $295 | No Gap Coverage | No | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
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AARP MedicareRx Preferred - S5820-025 Benefit Details ![]() |
$31.10 | $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): $84.30 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
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UnitedHealth Rx Basic - S5921-262 Benefit Details ![]() |
$32.90 | $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): $98.00 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 | ||||||
AdvantraRx Premier - S5674-039 Benefit Details ![]() |
$33.60 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 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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Prescriba Rx Gold - S5597-058 Benefit Details ![]() |
$33.70 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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Humana PDP Enhanced S5884-024 - S5884-024 Benefit Details ![]() |
$34.50 | $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 Rx Covg - Silver Plan - S5755-064 Benefit Details ![]() |
$35.30 | $150 | 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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UA Medicare Part D Prescription Drug Cov - S5755-029 Benefit Details ![]() |
$36.90 | $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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Sterling Rx - S4802-016 Benefit Details ![]() |
$37.80 | $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 | ||||||
CIGNA Medicare Rx Plan Two - S5617-130 Benefit Details ![]() |
$38.60 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $33.00 Tier 4: $80.00 Tier 5: 33% | 4,053 Browse Formulary | ||
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Health Net Orange Option 2 - S5678-057 Benefit Details ![]() |
$41.20 | $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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Medco Medicare Prescription Plan - Choice - S5660-026 Benefit Details ![]() |
$42.50 | $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 | ||||||
EnvisionRxPlus Gold - S7694-060 Benefit Details ![]() |
$43.80 | $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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SilverScript Plus - S5601-053 Benefit Details ![]() |
$44.60 | $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 Choice - S5803-163 Benefit Details ![]() |
$48.30 | $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 | ||||||
AdvantraRx Premier Plus - S5674-041 Benefit Details ![]() |
$49.20 | $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 - S5810-162 Benefit Details ![]() |
$57.80 | $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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SilverScript Complete - S5601-097 Benefit Details ![]() |
$62.80 | $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 | ||||||
Community CCRx Gold - S5803-243 Benefit Details ![]() |
$63.10 | $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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CIGNA Medicare Rx Plan Three - S5617-196 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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Medco Medicare Prescription Plan - Access - S5660-196 Benefit Details ![]() |
$69.00 | $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 | ||||||
Blue Medicare Rx - Plus - S5715-004 Benefit Details ![]() |
$70.90 | $0 | All Generics | No | Generic: $5.00 Preferred Brand: $38.00 Brand: $60.00 Specialty: 30% | 3,061 Browse Formulary | ||
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Prescriba Rx Platinum - S5597-223 Benefit Details ![]() |
$71.70 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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SierraRx Basic - S5917-027 Benefit Details ![]() |
$74.60 | $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 | ||||||
AARP MedicareRx Enhanced - S5921-263 Benefit Details ![]() |
$75.50 | $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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Humana PDP Complete S5884-054 - S5884-054 Benefit Details ![]() |
$95.10 | $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 - S5810-196 Benefit Details ![]() |
$104.00 | $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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