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 - S5768-096 Benefit Details ![]() |
$16.90 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $46.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
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First Health Part D-Premier - S5768-017 Benefit Details ![]() |
$23.00 | $0 | No Gap Coverage | Yes | Preferred Generic: $7.00 Preferred Brand: $29.00 Non-Preferred Generic/Non-Preferred Brand: $56.00 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 | ||||||
AdvantraRx Value - S5670-075 Benefit Details ![]() |
$23.40 | $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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SilverScript Value - S5601-028 Benefit Details ![]() |
$25.10 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $35.50 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
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AARP MedicareRx Saver - S5921-051 Benefit Details ![]() |
$25.80 | $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): $62.20 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 | ||||||
Prescriba Rx Bronze - S5597-248 Benefit Details ![]() |
$27.30 | $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 - S5803-083 Benefit Details ![]() |
$27.90 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 55% | 3,285 Browse Formulary | ||
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MedicareRx Rewards Standard - S5960-120 Sanctioned Plan ![]() |
$28.10 | $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 | ||||||
Medco Medicare Prescription Plan - Value - S5660-116 Benefit Details ![]() |
$28.50 | $295 | No Gap Coverage | No | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
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Advantage Star Plan by RxAmerica - S5644-189 Benefit Details ![]() |
$28.60 | $295 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
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HealthSpring Prescription Drug Plan-Reg 14 - S5932-013 Benefit Details ![]() |
$29.60 | $295 | No Gap Coverage | No | 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 | ||||||
EnvisionRxPlus Silver - S7694-014 Benefit Details ![]() |
$30.30 | $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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Health Net Orange Option 1 - S5678-034 Benefit Details ![]() |
$30.90 | $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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BravoRx - S5998-011 Benefit Details ![]() |
$31.00 | $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 | ||||||
Advantage Freedom Plan by RxAmerica - S5644-175 Benefit Details ![]() |
$31.20 | $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 - S5810-048 Benefit Details ![]() |
$31.80 | $200 | No Gap Coverage | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $30.00 Tier 4 - Non-Preferred Brand: $72.00 Tier 5 - Specialty: 25% | 5,374 Browse Formulary | ||
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Blue MedicareRx Value - S5596-013 Sanctioned Plan ![]() |
$32.00 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $41.50 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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Prescriba Rx Gold - S5597-046 Benefit Details ![]() |
$32.10 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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WellCare Signature - S5967-048 Sanctioned Plan ![]() |
$33.50 | $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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WellCare Classic - S5967-151 Sanctioned Plan ![]() |
$37.00 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $30.00 Tier 3: $67.00 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 | ||||||
UA Medicare Part D Rx Covg - Silver Plan - S5755-052 Benefit Details ![]() |
$37.80 | $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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AARP MedicareRx Preferred - S5820-013 Benefit Details ![]() |
$38.20 | $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): $84.10 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
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Sterling Rx - S4802-026 Benefit Details ![]() |
$38.20 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AdvantraRx Premier - S5670-076 Benefit Details ![]() |
$39.50 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 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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Humana PDP Enhanced S5884-012 - S5884-012 Benefit Details ![]() |
$39.50 | $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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Medco Medicare Prescription Plan - Choice - S5660-014 Benefit Details ![]() |
$40.90 | $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 | ||||||
CIGNA Medicare Rx Plan One - S5617-068 Benefit Details ![]() |
$41.10 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $31.00 Tier 3: $72.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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CIGNA Medicare Rx Plan Two - S5617-070 Benefit Details ![]() |
$41.40 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $38.00 Tier 4: $81.00 Tier 5: 33% | 4,053 Browse Formulary | ||
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Health Net Value Orange Option 2 - S5678-033 Benefit Details ![]() |
$41.50 | $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 | ||||||
Blue MedicareRx Plus - S5596-014 Sanctioned Plan ![]() |
$42.40 | $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 Standard S5884-072 - S5884-072 Benefit Details ![]() |
$42.70 | $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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UnitedHealth Rx Basic - S5921-052 Benefit Details ![]() |
$42.80 | $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 | ||||||
UPMC for Life Prescription Drug Plan - S8201-001 Benefit Details ![]() |
$44.10 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $32.00 Non-Preferred Brand: $80.00 Specialty: 33% | 3,843 Browse Formulary | ||
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UA Medicare Part D Prescription Drug Cov - S5755-017 Benefit Details ![]() |
$45.80 | $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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Community CCRx Choice - S5803-151 Benefit Details ![]() |
$46.10 | $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 | ||||||
SilverScript Plus - S5601-029 Benefit Details ![]() |
$50.10 | $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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Aetna Medicare Rx - Costco Plus Plan - S5810-150 Benefit Details ![]() |
$51.60 | $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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AdvantraRx Premier Plus - S5670-078 Benefit Details ![]() |
$56.10 | $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 | ||||||
SierraRx Basic - S5917-017 Benefit Details ![]() |
$61.40 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 Browse Formulary | ||
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Prescriba Rx Platinum - S5597-211 Benefit Details ![]() |
$65.40 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
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CIGNA Medicare Rx Plan Three - S5617-184 Benefit Details ![]() |
$65.50 | $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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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 - S5660-184 Benefit Details ![]() |
$66.40 | $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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SilverScript Complete - S5601-085 Benefit Details ![]() |
$67.50 | $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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EnvisionRxPlus Gold - S7694-048 Benefit Details ![]() |
$70.40 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AARP MedicareRx Enhanced - S5921-053 Benefit Details ![]() |
$73.30 | $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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Blue MedicareRx Premier - S5596-015 Sanctioned Plan ![]() |
$77.80 | $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 | ||
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Community CCRx Gold - S5803-231 Benefit Details ![]() |
$78.40 | $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 | ||||||
Aetna Medicare Rx Premier - S5810-184 Benefit Details ![]() |
$94.90 | $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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Humana PDP Complete S5884-042 - S5884-042 Benefit Details ![]() |
$97.50 | $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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