2009 Medicare Part D Plan Information Click here to jump to the Chart Legend & Search Tips | ||||||||
---|---|---|---|---|---|---|---|---|
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 |
||||||
First Health Part D-Secure - S5768-112 Benefit Details ![]() |
$16.70 | $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 | ||
![]() |
![]() |
![]() |
||||||
AdvantraRx Value - S5674-044 Benefit Details ![]() |
$21.60 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $50.00 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 | ||||||
HealthSpring Prescription Drug Plan-Reg 30 - S5932-029 Benefit Details ![]() |
$24.30 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
AARP MedicareRx Saver - S5921-021 Benefit Details ![]() |
$26.70 | $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): $61.10 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Medco Medicare Prescription Plan - Value - S5660-132 Benefit Details ![]() |
$29.50 | $295 | No Gap Coverage | Yes | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 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 - S5601-060 Benefit Details ![]() |
$29.90 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $32.50 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
First Health Part D-Premier - S5768-123 Benefit Details ![]() |
$30.00 | $0 | No Gap Coverage | Yes | Preferred Generic: $7.00 Preferred Brand: $26.00 Non-Preferred Generic/Non-Preferred Brand: $58.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Prescriba Rx Bronze - S5597-264 Benefit Details ![]() |
$30.60 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 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 | ||||||
Community CCRx Basic - S5803-099 Benefit Details ![]() |
$31.00 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 45% | 3,285 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Prescriba Rx Gold - S5597-062 Benefit Details ![]() |
$31.40 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Aetna Medicare Rx Essentials - S5810-064 Benefit Details ![]() |
$32.20 | $230 | No Gap Coverage | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $15.00 Tier 3 - Preferred Brand: $27.00 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 | ||||||
MedicareRx Rewards Standard - S5960-136 Sanctioned Plan ![]() |
$32.20 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5.: 25% | 41 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Health Net Orange Option 1 - S5678-006 Benefit Details ![]() |
$32.30 | $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 | ||
![]() |
![]() |
![]() |
||||||
SierraRx - S5917-006 Benefit Details ![]() |
$32.90 | $0 | No Gap Coverage | No | Generic: $9.25 Brand: $45.00 Specialty: 33% | 2,469 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
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 - S5644-062 Benefit Details ![]() |
$34.40 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: 35% Specialty: 33% Non-Preferred: 45% | 2,922 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
EnvisionRxPlus Silver - S7694-030 Benefit Details ![]() |
$34.40 | $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 | ||
![]() |
![]() |
![]() |
||||||
WellCare Classic - S5967-167 Sanctioned Plan ![]() |
$34.40 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $33.00 Tier 3: $87.00 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 | ||||||
Advantage Star Plan by RxAmerica - S5644-083 Benefit Details ![]() |
$34.80 | $295 | No Gap Coverage | No | Preferred Generic: $5.25 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
MedicareRx Rewards Value - S5960-030 Sanctioned Plan ![]() |
$36.00 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred Brand or Generic: $85.00 Tier 4 Non-Specialty Injectable: 29% Tier 5.: 29% | 3,708 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
CIGNA Medicare Rx Plan One - S5617-148 Benefit Details ![]() |
$36.30 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $33.00 Tier 3: $82.00 Tier 4: 25% | 4,053 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 Enhanced S5884-028 - S5884-028 Benefit Details ![]() |
$36.50 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Humana PDP Standard S5884-088 - S5884-088 Benefit Details ![]() |
$37.90 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 47% | 4,828 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Sterling Rx - S4802-020 Benefit Details ![]() |
$37.90 | $295 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Brand: $58.00 Specialty: 25% | 5,234 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 Preferred - S5820-029 Benefit Details ![]() |
$38.40 | $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): $81.20 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
WellCare Signature - S5967-064 Sanctioned Plan ![]() |
$41.50 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $39.00 Tier 3: $79.00 Tier 4: 33% | 2,718 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Community CCRx Choice - S5803-167 Benefit Details ![]() |
$41.70 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
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 - S5755-068 Benefit Details ![]() |
$42.00 | $130 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 25% | 3,499 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
UnitedHealth Rx Basic - S5921-022 Benefit Details ![]() |
$43.10 | $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): $94.00 Tier 4 - Specialty (Generic, Brand): 33% | 4,548 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
AdvantraRx Premier - S5674-045 Benefit Details ![]() |
$44.20 | $0 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: $27.00 Non-Preferred Generic/Non-Preferred Brand: $71.00 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 | ||||||
UA Medicare Part D Prescription Drug Cov - S5755-033 Benefit Details ![]() |
$45.40 | $0 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $33.00 Non-Preferred Brand: $66.00 Specialty: 33% | 3,607 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Community CCRx Gold - S5803-247 Benefit Details ![]() |
$46.40 | $0 | All Generics | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Medco Medicare Prescription Plan - Choice - S5660-030 Benefit Details ![]() |
$47.70 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $38.00 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 | ||||||
Health Net Orange Option 2 - S5678-012 Benefit Details ![]() |
$48.20 | $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 | ||
![]() |
![]() |
![]() |
||||||
CIGNA Medicare Rx Plan Two - S5617-150 Benefit Details ![]() |
$49.80 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $38.00 Tier 4: $83.00 Tier 5: 33% | 4,053 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
SilverScript Plus - S5601-061 Benefit Details ![]() |
$56.80 | $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 | ||
![]() |
![]() |
![]() |
||||||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AdvantraRx Premier Plus - S5674-047 Benefit Details ![]() |
$59.50 | $0 | Many Generics | No | Preferred Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $74.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Aetna Medicare Rx - Costco Plus Plan - S5810-166 Benefit Details ![]() |
$59.50 | $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 | ||
![]() |
![]() |
![]() |
||||||
EnvisionRxPlus Gold - S7694-064 Benefit Details ![]() |
$63.10 | $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 | ||
![]() |
![]() |
![]() |
||||||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Asuris Medicare Script - S5609-001 Benefit Details ![]() |
$64.50 | $295 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Brand: $40.00 Miscellaneous Injectables: 25% Specialty: 25% | 5,363 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Prescriba Rx Platinum - S5597-227 Benefit Details ![]() |
$66.90 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
SierraRx Basic - S5917-031 Benefit Details ![]() |
$71.00 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 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 - Access - S5660-200 Benefit Details ![]() |
$76.60 | $0 | All Generics | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
AARP MedicareRx Enhanced - S5921-023 Benefit Details ![]() |
$79.10 | $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 | ||
![]() |
![]() |
![]() |
||||||
SilverScript Complete - S5601-101 Benefit Details ![]() |
$79.40 | $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 | ||||||
CIGNA Medicare Rx Plan Three - S5617-200 Benefit Details ![]() |
$80.10 | $0 | Some Generics | No | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | 4,386 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Asuris Medicare Script Enhanced - S5609-002 Benefit Details ![]() |
$81.00 | $0 | Many Generics | No | Generic: $4.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Miscellaneous Injectables: 25% Specialty Medications: 25% | 5,363 Browse Formulary | ||
![]() |
![]() |
![]() |
||||||
Humana PDP Complete S5884-058 - S5884-058 Benefit Details ![]() |
$104.60 | $0 | Many Generics | 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 | ||||||
Aetna Medicare Rx Premier - S5810-200 Benefit Details ![]() |
$120.60 | $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 | ||
![]() |
![]() |
![]() |
|