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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SierraRx UnitedHealth Rx Value - S5917-005 Benefit Details |
$19.00 | $0 | No Gap Coverage | No | Generic: $8.00 Brand: $50.00 Specialty: 33% | 2,469 Browse Formulary | ||
First Health Part D-Secure - S5768-111 Benefit Details |
$19.40 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $50.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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 - S5768-031 Benefit Details |
$20.20 | $0 | No Gap Coverage | Yes | Preferred Generic: $6.00 Preferred Brand: $25.00 Non-Preferred Generic/Non-Preferred Brand: $67.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
MedicareRx Rewards Standard - S5960-135 Sanctioned Plan |
$22.00 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5.: 25% | 41 Browse Formulary | ||
WellCare Classic - S5967-166 Sanctioned Plan |
$22.50 | $200 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $30.00 Tier 3: $78.00 Tier 4: 25% | 2,718 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
SilverScript Value - S5601-058 Benefit Details |
$23.60 | $295 | No Gap Coverage | No | Generic: $8.00 Preferred Brand: $36.75 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
HealthSpring Prescription Drug Plan-Reg 29 - S5932-028 Benefit Details |
$23.90 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
AdvantraRx Value - S5670-147 Benefit Details |
$25.10 | $0 | No Gap Coverage | No | Preferred Generic: $9.00 Preferred Brand: $26.00 Non-Preferred Generic/Non-Preferred Brand: $65.00 Specialty-Generic and Brand: 33% | 3,149 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Community CCRx Basic - S5803-098 Benefit Details |
$25.50 | $295 | No Gap Coverage | No | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 50% | 3,285 Browse Formulary | ||
Blue MedicareRx Value - S5596-029 Sanctioned Plan |
$26.20 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $43.00 Tier 3 Non-Preferred Brand or Generic: $85.00 Tier 4 Non-Specialty Injectable: 29% Tier 5.: 29% | 3,708 Browse Formulary | ||
EnvisionRxPlus Silver - S7694-029 Benefit Details |
$27.90 | $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 | ||
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 - S5678-062 Benefit Details |
$28.30 | $295 | No Gap Coverage | No | Preferred Generic: $2.00 Preferred Brand: $44.00 Non-Preferred Brand: $90.00 Injectable: 25% Specialty: 25% | 4,743 Browse Formulary | ||
Medco Medicare Prescription Plan - Value - S5660-131 Benefit Details |
$29.10 | $295 | No Gap Coverage | No | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
Advantage Star Plan by RxAmerica - S5644-082 Benefit Details |
$29.40 | $295 | No Gap Coverage | No | Preferred Generic: $5.50 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
BravoRx - S5998-033 Benefit Details |
$29.70 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
Prescriba Rx Bronze - S5597-263 Benefit Details |
$30.50 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
Advantage Freedom Plan by RxAmerica - S5644-061 Benefit Details |
$32.20 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: 35% Specialty: 33% Non-Preferred: 45% | 2,922 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
WellCare Signature - S5967-063 Sanctioned Plan |
$32.20 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $39.00 Tier 3: $79.00 Tier 4: 33% | 2,718 Browse Formulary | ||
SierraRx Basic - S5917-030 Benefit Details |
$33.10 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 Browse Formulary | ||
AARP MedicareRx Saver - S5921-265 Benefit Details |
$33.30 | $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): $56.10 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
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 - S5617-143 Benefit Details |
$33.40 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $28.00 Tier 3: $80.00 Tier 4: 25% | 4,053 Browse Formulary | ||
AARP MedicareRx Preferred - S5820-028 Benefit Details |
$34.20 | $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): $86.30 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
Prescriba Rx Gold - S5597-061 Benefit Details |
$38.80 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Sterling Rx - S4802-019 Benefit Details |
$39.20 | $295 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Brand: $58.00 Specialty: 25% | 5,234 Browse Formulary | ||
UA Medicare Part D Rx Covg - Silver Plan - S5755-067 Benefit Details |
$40.70 | $180 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 25% | 3,499 Browse Formulary | ||
Aetna Medicare Rx Essentials - S5810-063 Benefit Details |
$41.40 | $195 | No Gap Coverage | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $26.00 Tier 4 - Non-Preferred Brand: $67.00 Tier 5 - Specialty: 25% | 5,374 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Humana PDP Standard S5884-087 - S5884-087 Benefit Details |
$41.40 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 44% | 4,828 Browse Formulary | ||
UnitedHealth Rx Basic - S5921-266 Benefit Details |
$42.10 | $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 | ||
Humana PDP Enhanced S5884-027 - S5884-027 Benefit Details |
$44.00 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
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 - S5660-029 Benefit Details |
$44.40 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $38.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
CIGNA Medicare Rx Plan Two - S5617-145 Benefit Details |
$44.50 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $38.00 Tier 4: $82.00 Tier 5: 33% | 4,053 Browse Formulary | ||
AdvantraRx Premier - S5670-148 Benefit Details |
$46.20 | $0 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $74.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Blue MedicareRx Plus - S5596-030 Sanctioned Plan |
$46.80 | $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 | ||
UA Medicare Part D Prescription Drug Cov - S5755-032 Benefit Details |
$47.40 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $32.00 Non-Preferred Brand: $64.00 Specialty: 33% | 3,607 Browse Formulary | ||
Health Net Orange Option 2 - S5678-061 Benefit Details |
$49.10 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Community CCRx Choice - S5803-166 Benefit Details |
$53.90 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
EnvisionRxPlus Gold - S7694-063 Benefit Details |
$56.80 | $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 | ||
SilverScript Plus - S5601-059 Benefit Details |
$57.10 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AdvantraRx Premier Plus - S5670-150 Benefit Details |
$62.70 | $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 | ||
Aetna Medicare Rx - Costco Plus Plan - S5810-165 Benefit Details |
$66.40 | $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 | ||
Medco Medicare Prescription Plan - Access - S5660-199 Benefit Details |
$69.60 | $0 | All Generics | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Platinum - S5597-226 Benefit Details |
$72.50 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
Community CCRx Gold - S5803-246 Benefit Details |
$72.80 | $0 | All Generics | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
SilverScript Complete - S5601-100 Benefit Details |
$75.40 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AARP MedicareRx Enhanced - S5921-273 Benefit Details |
$77.00 | $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 | ||
Blue MedicareRx Premier - S5596-031 Sanctioned Plan |
$78.80 | $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 | ||
CIGNA Medicare Rx Plan Three - S5617-199 Benefit Details |
$80.40 | $0 | Some Generics | No | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | 4,386 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Humana PDP Complete S5884-057 - S5884-057 Benefit Details |
$104.30 | $0 | Many Generics | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
Aetna Medicare Rx Premier - S5810-199 Benefit Details |
$116.00 | $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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