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 - S5768-088 Benefit Details ![]() |
$13.70 | $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 | ||
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AdvantraRx Value - S5670-033 Benefit Details ![]() |
$22.20 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AARP MedicareRx Saver - S5921-091 Benefit Details ![]() |
$22.40 | $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): $60.05 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
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Community CCRx Basic - S5803-075 Benefit Details ![]() |
$25.40 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 45% | 3,285 Browse Formulary | ||
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Advantage Star Plan by RxAmerica - S5644-072 Benefit Details ![]() |
$27.80 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
MedicareRx Rewards Standard - S5960-112 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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Medco Medicare Prescription Plan - Value - S5660-108 Benefit Details ![]() |
$28.50 | $295 | No Gap Coverage | Yes | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 52% Specialty: 25% | 3,499 Browse Formulary | ||
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AmeriHealth Advantage Rx Option I - S2770-001 Benefit Details ![]() |
$28.60 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 4,119 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 | ||||||
First Health Part D-Premier - S5768-009 Benefit Details ![]() |
$28.70 | $0 | No Gap Coverage | Yes | Preferred Generic: $7.00 Preferred Brand: $27.00 Non-Preferred Generic/Non-Preferred Brand: $52.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
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SilverScript Value - S5601-012 Benefit Details ![]() |
$28.70 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $31.00 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
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Prescriba Rx Bronze - S5597-240 Benefit Details ![]() |
$28.80 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 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 | ||||||
HealthSpring Prescription Drug Plan -Reg 6 - S5932-006 Benefit Details ![]() |
$29.90 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
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CIGNA Medicare Rx Plan One - S5617-028 Benefit Details ![]() |
$30.00 | $295 | No Gap Coverage | No | Tier 1: $2.50 Tier 2: $30.00 Tier 3: $94.00 Tier 4: 25% | 4,053 Browse Formulary | ||
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WellCare Classic - S5967-143 Sanctioned Plan ![]() |
$31.40 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $31.00 Tier 3: $78.00 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 | ||||||
BravoRx - S5998-005 Benefit Details ![]() |
$31.60 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
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EnvisionRxPlus Silver - S7694-006 Benefit Details ![]() |
$32.00 | $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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Prescriba Rx Gold - S5597-038 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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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 - S5660-005 Benefit Details ![]() |
$32.60 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: 75% Specialty: 33% | 3,607 Browse Formulary | ||
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MedicareRx Rewards Value - S5960-006 Sanctioned Plan ![]() |
$32.90 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $10.00 Tier 2 Preferred Brand: $40.50 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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BlueRx Value - S5593-004 Benefit Details ![]() |
$33.10 | $295 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $32.00 Non-Preferred Brand: $62.00 Specialty: 25% | 5,080 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 - S5810-040 Benefit Details ![]() |
$33.40 | $195 | No Gap Coverage | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $11.00 Tier 3 - Preferred Brand: $29.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: 25% | 5,374 Browse Formulary | ||
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WellCare Signature - S5967-040 Sanctioned Plan ![]() |
$33.90 | $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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AARP MedicareRx Preferred - S5820-005 Benefit Details ![]() |
$34.80 | $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): $91.50 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 | ||||||
Health Net Orange Option 1 - S5678-018 Benefit Details ![]() |
$35.30 | $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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AdvantraRx Premier - S5670-034 Benefit Details ![]() |
$36.90 | $0 | No Gap Coverage | No | Preferred Generic: $5.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $76.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
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Advantage Freedom Plan by RxAmerica - S5644-051 Benefit Details ![]() |
$38.30 | $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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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 - S5755-044 Benefit Details ![]() |
$39.00 | $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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CIGNA Medicare Rx Plan Two - S5617-030 Benefit Details ![]() |
$39.50 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $40.00 Tier 4: $83.00 Tier 5: 33% | 4,053 Browse Formulary | ||
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Humana PDP Standard S5884-064 - S5884-064 Benefit Details ![]() |
$39.50 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 46% | 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 | ||||||
Sterling Rx - S4802-003 Benefit Details ![]() |
$42.10 | $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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UA Medicare Part D Prescription Drug Cov - S5755-009 Benefit Details ![]() |
$42.40 | $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 - S5803-143 Benefit Details ![]() |
$42.60 | $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 | ||||||
SecureRx - Option 4 - S8067-004 Benefit Details ![]() |
$43.00 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,827 Browse Formulary | ||
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UnitedHealth Rx Basic - S5921-092 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): $98.00 Tier 4 - Specialty (Generic, Brand): 33% | 4,548 Browse Formulary | ||
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UPMC for Life Prescription Drug Plan - S3389-005 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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Geisinger Gold Rx 1 - S4248-001 Benefit Details ![]() |
$44.50 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% | 2,081 Browse Formulary | ||
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SecureRx - Option 3 - S8067-001 Benefit Details ![]() |
$44.60 | $0 | No Gap Coverage | No | Generic Drugs: $9.00 Formulary Brand Drugs: $50.00 Specialty Drugs: 30% | 2,827 Browse Formulary | ||
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Humana PDP Enhanced S5884-005 - S5884-005 Benefit Details ![]() |
$44.90 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Health Net Value Orange Option 2 - S5678-017 Benefit Details ![]() |
$46.60 | $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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BlueRx Plus - S5593-002 Benefit Details ![]() |
$49.10 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 5,080 Browse Formulary | ||
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SilverScript Plus - S5601-013 Benefit Details ![]() |
$51.50 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
AdvantraRx Premier Plus - S5670-036 Benefit Details ![]() |
$52.80 | $0 | Many Generics | No | Preferred Generic: $4.00 Preferred Brand: $29.00 Non-Preferred Generic/Non-Preferred Brand: $74.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
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AmeriHealth Rx Option I - S2321-001 Benefit Details ![]() |
$54.30 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 4,790 Browse Formulary | ||
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AmeriHealth Rx Option II - S2321-002 Benefit Details ![]() |
$58.90 | $0 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $30.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,790 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 Plus - S5810-142 Benefit Details ![]() |
$63.90 | $0 | Some Generics | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $10.00 Tier 3 - Preferred Brand: $40.00 Tier 4 - Non-Preferred Brand: $86.00 Tier 5 - Specialty: 33% | 5,374 Browse Formulary | ||
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SierraRx Basic - S5917-011 Benefit Details ![]() |
$64.90 | $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 - S5597-203 Benefit Details ![]() |
$65.00 | $0 | All Generics | 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 | ||||||
EnvisionRxPlus Gold - S7694-040 Benefit Details ![]() |
$66.60 | $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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Medco Medicare Prescription Plan - Access - S5660-176 Benefit Details ![]() |
$68.30 | $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 - S5601-077 Benefit Details ![]() |
$69.10 | $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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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 - S5617-176 Benefit Details ![]() |
$72.60 | $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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Community CCRx Gold - S5803-223 Benefit Details ![]() |
$75.10 | $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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AARP MedicareRx Enhanced - S5921-093 Benefit Details ![]() |
$76.40 | $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 | ||||||
SecureRx - Option 1 - S8067-003 Benefit Details ![]() |
$86.90 | $0 | Many Generics | No | Generic Drugs: $7.00 Preferred Brand Drugs: $35.00 Non-preferred Brand Drugs: $85.00 Specialty Drugs: 30% | 4,734 Browse Formulary | ||
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Humana PDP Complete S5884-034 - S5884-034 Benefit Details ![]() |
$95.40 | $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 - S5810-176 Benefit Details ![]() |
$99.90 | $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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Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
BlueRx Complete - S5593-003 Benefit Details ![]() |
$108.00 | $0 | Many Generics | No | Generic: $5.00 Preferred Brand: $25.00 Non-Preferred Brand: $55.00 Specialty: 33% | 5,080 Browse Formulary | ||
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