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 - S5768-091 Benefit Details |
$15.20 | $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 - S5670-051 Benefit Details |
$23.10 | $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 | ||
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 - S5768-012 Benefit Details |
$27.00 | $0 | No Gap Coverage | Yes | Preferred Generic: $6.00 Preferred Brand: $29.00 Non-Preferred Generic/Non-Preferred Brand: $59.00 Specialty-Generic and Brand: 33% | 3,393 Browse Formulary | ||
Medco Medicare Prescription Plan - Value - S5660-111 Benefit Details |
$27.80 | $295 | No Gap Coverage | Yes | Generic: 23% Preferred Brand: 23% Non-Preferred Brand: 53% Specialty: 25% | 3,499 Browse Formulary | ||
Windsor Rx - S2505-007 Benefit Details |
$28.20 | $170 | 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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
SilverScript Value - S5601-018 Benefit Details |
$28.30 | $295 | No Gap Coverage | Yes | Generic: $8.00 Preferred Brand: $32.75 Non-Preferred Brand: $98.00 Specialty: 25% | 5,320 Browse Formulary | ||
AARP MedicareRx Saver - S5921-121 Benefit Details |
$28.50 | $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): $63.70 Tier 4 - Specialty (Generic, Brand): 25% | 4,548 Browse Formulary | ||
HealthSpring Prescription Drug Plan -Reg 9 - S5932-009 Benefit Details |
$28.60 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,420 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
BravoRx - S5998-018 Benefit Details |
$28.70 | $295 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,438 Browse Formulary | ||
Community CCRx Basic - S5803-078 Benefit Details |
$30.00 | $295 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 60% | 3,285 Browse Formulary | ||
Prescriba Rx Bronze - S5597-243 Benefit Details |
$30.00 | $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 | ||||||
MedicareRx Rewards Standard - S5960-115 Sanctioned Plan |
$30.50 | $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 - S5644-075 Benefit Details |
$30.80 | $295 | No Gap Coverage | Yes | Preferred Generic: $5.00 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,922 Browse Formulary | ||
Aetna Medicare Rx Essentials - S5810-043 Benefit Details |
$31.30 | $215 | No Gap Coverage | Yes | 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 | ||||||
CIGNA Medicare Rx Plan One - S5617-043 Benefit Details |
$31.50 | $295 | No Gap Coverage | Yes | Tier 1: $2.50 Tier 2: $28.00 Tier 3: $76.00 Tier 4: 25% | 4,053 Browse Formulary | ||
WellCare Classic - S5967-146 Sanctioned Plan |
$31.50 | $295 | No Gap Coverage | Yes | Tier 1: $0.00 Tier 2: $34.00 Tier 3: $81.00 Tier 4: 25% | 2,718 Browse Formulary | ||
EnvisionRxPlus Silver - S7694-009 Benefit Details |
$31.90 | $295 | No Gap Coverage | Yes | 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 | ||||||
PerformRx Option I - S5650-001 Benefit Details |
$32.10 | $295 | No Gap Coverage | No | cost-sharing data not available. | tbd Browse Formulary | ||
InStil Rx - S5946-001 Benefit Details |
$32.50 | $295 | No Gap Coverage | No | Tier 1: 25% | 3,408 Browse Formulary | ||
Advantage Freedom Plan by RxAmerica - S5644-054 Benefit Details |
$33.00 | $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 | ||||||
Health Net Orange Option 1 - S5678-024 Benefit Details |
$33.30 | $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 | ||
MedBlue Rx - S5953-001 Benefit Details |
$33.60 | $0 | No Gap Coverage | No | Generic: $8.00 Brand: $41.00 Specialty: 33% | 3,020 Browse Formulary | ||
MedicareRx Rewards Value - S5960-009 Sanctioned Plan |
$34.70 | $130 | No Gap Coverage | No | Tier 1 Preferred Generic: $8.00 Tier 2 Preferred Brand: $44.00 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 - S5597-041 Benefit Details |
$35.40 | $0 | No Gap Coverage | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
CIGNA Medicare Rx Plan Two - S5617-045 Benefit Details |
$36.00 | $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 | ||
Medco Medicare Prescription Plan - Choice - S5660-008 Benefit Details |
$36.80 | $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 | ||||||
WellCare Signature - S5967-043 Sanctioned Plan |
$38.50 | $0 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $39.00 Tier 3: $79.00 Tier 4: 33% | 2,718 Browse Formulary | ||
AdvantraRx Premier - S5670-052 Benefit Details |
$38.80 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $28.00 Non-Preferred Generic/Non-Preferred Brand: $67.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
PerformRx Option II - S5650-003 Benefit Details |
$39.70 | $265 | No Gap Coverage | No | cost-sharing data not available. | tbd 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 - S5820-008 Benefit Details |
$40.00 | $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): $79.65 Tier 4 - Specialty (Generic, Brand): 33% | 5,357 Browse Formulary | ||
Sterling Rx - S4802-006 Benefit Details |
$40.30 | $295 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $25.00 Non-Preferred Brand: $57.00 Specialty: 25% | 5,234 Browse Formulary | ||
UnitedHealth Rx Basic - S5921-122 Benefit Details |
$41.00 | $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): $93.00 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 Rx Covg - Silver Plan - S5755-047 Benefit Details |
$41.20 | $130 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 25% | 3,499 Browse Formulary | ||
Humana PDP Standard S5884-067 - S5884-067 Benefit Details |
$42.20 | $295 | No Gap Coverage | No | Preferred Generic: 15% Preferred Brand: 25% Other - Non-Preferred (Gen/Brand): 46% | 4,828 Browse Formulary | ||
UA Medicare Part D Prescription Drug Cov - S5755-012 Benefit Details |
$44.60 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $31.00 Non-Preferred Brand: $62.00 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 | ||||||
Humana PDP Enhanced S5884-008 - S5884-008 Benefit Details |
$46.70 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $70.00 Specialty: 33% | 4,828 Browse Formulary | ||
Health Net Value Orange Option 2 - S5678-023 Benefit Details |
$47.60 | $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 | ||
SilverScript Plus - S5601-019 Benefit Details |
$52.80 | $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 - S5670-054 Benefit Details |
$54.60 | $0 | Many Generics | No | Preferred Generic: $4.00 Preferred Brand: $32.00 Non-Preferred Generic/Non-Preferred Brand: $76.00 Specialty-Generic and Brand: 33% | 3,399 Browse Formulary | ||
Community CCRx Choice - S5803-146 Benefit Details |
$55.60 | $0 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 3,287 Browse Formulary | ||
Aetna Medicare Rx Plus - S5810-145 Benefit Details |
$59.60 | $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: $77.00 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 | ||||||
EnvisionRxPlus Gold - S7694-043 Benefit Details |
$64.40 | $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 | ||
InStil Rx Plus - S5946-003 Benefit Details |
$65.90 | $0 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: $36.00 Brand: $72.00 Specialty: 33% | 3,724 Browse Formulary | ||
SilverScript Complete - S5601-080 Benefit Details |
$66.00 | $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 - S5617-179 Benefit Details |
$66.50 | $0 | Some Generics | No | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | 4,386 Browse Formulary | ||
SierraRx Basic - S5917-014 Benefit Details |
$66.70 | $295 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,469 Browse Formulary | ||
Medco Medicare Prescription Plan - Access - S5660-179 Benefit Details |
$68.10 | $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 - S5597-206 Benefit Details |
$70.70 | $0 | All Generics | No | Generic: $6.00 Brand: $44.00 Specialty: 33% | 3,223 Browse Formulary | ||
Community CCRx Gold - S5803-226 Benefit Details |
$70.80 | $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 - S5921-123 Benefit Details |
$71.00 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
MedBlue Rx Plus - S5953-002 Benefit Details |
$73.80 | $0 | Many Generics | No | Generic: $8.00 Preferred Brand: $38.00 Non-Preferred Brand: $65.00 Specialty: 33% | 5,350 Browse Formulary | ||
Humana PDP Complete S5884-037 - S5884-037 Benefit Details |
$97.90 | $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 - S5810-179 Benefit Details |
$100.50 | $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 | ||
|