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 - S5768-102 Benefit Details |
$18.00 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: $20.00 Non-Preferred Generic/Non-Preferred Brand: $45.00 Specialty-Generic and Brand: 28% | 3,128 Browse Formulary | ||
Advantage Freedom Plan by RxAmerica - S5644-181 Benefit Details |
$22.10 | $0 | No Gap Coverage | No | Preferred Generic: $4.50 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 | ||||||
Aetna Medicare Rx Essentials - S5810-054 Benefit Details |
$22.30 | $200 | No Gap Coverage | Yes | 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 | ||
SilverScript Value - S5601-040 Benefit Details |
$25.60 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $29.25 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
AARP MedicareRx Saver - S5921-321 Benefit Details |
$25.90 | $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): $53.40 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 | ||||||
AdvantraRx Value - S5670-105 Benefit Details |
$25.90 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Preferred Brand: $30.00 Non-Preferred Generic/Non-Preferred Brand: $62.00 Specialty-Generic and Brand: 33% | 3,149 Browse Formulary | ||
Prescriba Rx Bronze - S5597-254 Benefit Details |
$26.70 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,223 Browse Formulary | ||
Medco Medicare Prescription Plan - Value - S5660-122 Benefit Details |
$28.10 | $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 | ||||||
Windsor Rx - S2505-005 Benefit Details |
$28.20 | $190 | No Gap Coverage | Yes | Tier 1 - Preferred Generics: $10.00 Tier 2 - Preferred Brand: $25.00 Tier 3 - NonPreferred Brand, NonPreferred Generic: $50.00 Tier 4 - Speciality (Brand or Generic): 25% | 2,832 Browse Formulary | ||
BravoRx - S5998-025 Benefit Details |
$28.80 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
First Health Part D-Premier - S5768-120 Benefit Details |
$28.90 | $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 | ||
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 20 - S5932-019 Benefit Details |
$29.40 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
MedicareRx Rewards Standard - S5960-126 Sanctioned Plan |
$29.40 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5.: 25% | 41 Browse Formulary | ||
Advantage Star Plan by RxAmerica - S5644-195 Benefit Details |
$29.90 | $295 | No Gap Coverage | Yes | Preferred Generic: $5.00 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 | ||||||
Community CCRx Basic - S5803-089 Benefit Details |
$29.90 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 45% | 3,285 Browse Formulary | ||
CIGNA Medicare Rx Plan One - S5617-098 Benefit Details |
$31.20 | $295 | No Gap Coverage | Yes | Tier 1: $2.50 Tier 2: $30.00 Tier 3: $73.00 Tier 4: 25% | 4,053 Browse Formulary | ||
Medco Medicare Prescription Plan - Choice - S5660-020 Benefit Details |
$31.90 | $0 | No Gap Coverage | 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 | ||||||
WellCare Classic - S5967-157 Sanctioned Plan |
$32.50 | $295 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $35.00 Tier 3: $80.00 Tier 4: 25% | 2,718 Browse Formulary | ||
EnvisionRxPlus Silver - S7694-020 Benefit Details |
$32.80 | $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 | ||
MedicareRx Rewards Value - S5960-020 Sanctioned Plan |
$33.30 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $7.50 Tier 2 Preferred Brand: $40.00 Tier 3 Non-Preferred Brand or Generic: $85.00 Tier 4 Non-Specialty Injectable: 29% Tier 5.: 29% | 3,708 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 Gold - S5597-052 Benefit Details |
$34.60 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
Health Net Orange Option 1 - S5678-046 Benefit Details |
$35.90 | $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 | ||
WellCare Signature - S5967-054 Sanctioned Plan |
$37.40 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $39.00 Tier 3: $79.00 Tier 4: 33% | 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 | ||||||
UA Medicare Part D Rx Covg - Silver Plan - S5755-058 Benefit Details |
$38.80 | $140 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 25% | 3,499 Browse Formulary | ||
Sterling Rx - S4802-029 Benefit Details |
$39.00 | $295 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Brand: $57.00 Specialty: 25% | 5,234 Browse Formulary | ||
AARP MedicareRx Preferred - S5820-019 Benefit Details |
$39.50 | $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): $70.60 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 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 S5884-078 - S5884-078 Benefit Details |
$40.40 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 44% | 4,828 Browse Formulary | ||
AdvantraRx Premier - S5670-106 Benefit Details |
$42.80 | $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 | ||
CIGNA Medicare Rx Plan Two - S5617-100 Benefit Details |
$44.30 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $6.00 Tier 3: $38.00 Tier 4: $80.00 Tier 5: 33% | 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 | ||||||
Health Net Value Orange Option 2 - S5678-045 Benefit Details |
$44.40 | $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 | ||
Humana PDP Enhanced S5884-018 - S5884-018 Benefit Details |
$44.50 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
UnitedHealth Rx Basic - S5921-322 Benefit Details |
$44.50 | $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): $83.00 Tier 4 - Specialty (Generic, Brand): 33% | 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 | ||||||
UA Medicare Part D Prescription Drug Cov - S5755-023 Benefit Details |
$44.70 | $0 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $32.00 Non-Preferred Brand: $64.00 Specialty: 33% | 3,607 Browse Formulary | ||
Community CCRx Choice - S5803-157 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 - S7694-054 Benefit Details |
$56.30 | $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 | ||||||
AdvantraRx Premier Plus - S5670-108 Benefit Details |
$57.30 | $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 | ||
SilverScript Plus - S5601-041 Benefit Details |
$58.20 | $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 | ||
Aetna Medicare Rx Plus - S5810-156 Benefit Details |
$59.70 | $0 | Some Generics | No | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $10.00 Tier 3 - Preferred Brand: $36.00 Tier 4 - Non-Preferred Brand: $76.00 Tier 5 - Specialty: 33% | 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 | ||||||
CIGNA Medicare Rx Plan Three - S5617-190 Benefit Details |
$63.60 | $0 | Some Generics | No | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | 4,386 Browse Formulary | ||
Prescriba Rx Platinum - S5597-217 Benefit Details |
$65.20 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
Medco Medicare Prescription Plan - Access - S5660-190 Benefit Details |
$68.40 | $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 | ||||||
Community CCRx Gold - S5803-237 Benefit Details |
$69.20 | $0 | All Generics | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
AARP MedicareRx Enhanced - S5921-323 Benefit Details |
$70.80 | $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): $85.00 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
SilverScript Complete - S5601-091 Benefit Details |
$74.70 | $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 | ||||||
SierraRx Basic - S5917-022 Benefit Details |
$75.70 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 Browse Formulary | ||
Humana PDP Complete S5884-048 - S5884-048 Benefit Details |
$94.90 | $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 - S5810-190 Benefit Details |
$108.90 | $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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