2010 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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CIGNA Medicare Rx Plan One (PDP) - S5617-103 Benefit Details ![]() |
$25.10 | $310 | No Gap Coverage | Yes | Tier 1: $3.00 Tier 2: $29.00 Tier 3: $71.00 Tier 4: 25% | 3,458 Browse Formulary | ||
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PrescribaRx Bronze (PDP) - S5597-255 Benefit Details ![]() |
$25.40 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,852 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 | ||||||
WellCare Classic (PDP) - S5967-158 Benefit Details ![]() |
$26.90 | $310 | No Gap Coverage | tbd | Tier 1: $4.00 Tier 2: $32.00 Tier 3: $68.00 Tier 4: 25% | tbd Browse Formulary | ||
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Health Net Orange Option 1 (PDP) - S5678-048 Benefit Details ![]() |
$27.10 | $310 | No Gap Coverage | Yes | Tier 1 Preferred Generic : $4.00 Tier 2 Preferred Brand : $36.00 Tier 3 Non-Preferred: $95.00 Tier 4 Injectable: 25% Tier 5 Specialty: 25% | 3,650 Browse Formulary | ||
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Community CCRx Basic (PDP) - S5803-090 Benefit Details ![]() |
$27.20 | $310 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 50% | 2,887 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 (PDP) - S5768-044 Benefit Details ![]() |
$27.70 | $150 | No Gap Coverage | Yes | Preferred Generic: $9.00 Preferred Brand: 10% Non-Preferred Generic/Non-Preferred Brand: 42% Specialty - Generic and Brand: 29% | 3,031 Browse Formulary | ||
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Humana Value S5884-108 (PDP) - S5884-108 Benefit Details ![]() |
$27.70 | $150 | No Gap Coverage | No | Preferred Generic: $5.00 Non-Preferred Generics/Preferred Brand: $35.00 Non-Preferred Brand: 32% | 3,041 Browse Formulary | ||
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Medco Medicare Prescription Plan - Value (PDP) - S5660-123 Benefit Details ![]() |
$27.80 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,061 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 (PDP) - S5960-127 Benefit Details ![]() |
$28.70 | $310 | No Gap Coverage | Yes | Tier 1 Preferred Generic Drugs: $6.50 Tier 2 Preferred Brand Certain Generic Drugs: 25% Tier 3 Non-Specialty Injectable Drugs: 25% Tier 4 Specialty Drugs: 25% | 3,251 Browse Formulary | ||
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BravoRx (PDP) - S5998-026 Benefit Details ![]() |
$29.10 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,912 Browse Formulary | ||
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HealthSpring Prescription Drug Plan-Reg 21 (PDP) - S5932-020 Benefit Details ![]() |
$29.10 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,035 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 Star Plan by RxAmerica (PDP) - S5644-196 Benefit Details ![]() |
$29.80 | $310 | No Gap Coverage | Yes | Preferred Generic: $4.25 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,629 Browse Formulary | ||
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SilverScript Value (PDP) - S5601-042 Benefit Details ![]() |
$29.80 | $310 | No Gap Coverage | Yes | Generic Tier: $7.00 Preferred Brand Tier: $19.25 Non-Preferred Brand Tier: $95.00 Specialty Tier: 25% | 3,178 Browse Formulary | ||
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Fox Value Plan (PDP) - S5557-048 Sanctioned Plan ![]() |
$30.10 | $310 | No Gap Coverage | Yes | Tier 1: 0% Tier 2: 50% Tier 3: 40% Tier 4: 60% Tier 5: 25% | 2,826 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 (PDP) - S7694-021 Benefit Details ![]() |
$31.70 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | 2,318 Browse Formulary | ||
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CIGNA Medicare Rx Plan Two (PDP) - S5617-105 Benefit Details ![]() |
$31.90 | $100 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $8.00 Tier 3: $36.00 Tier 4: $84.00 Tier 5: 25% | 3,510 Browse Formulary | ||
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PrescribaRx Gold (PDP) - S5597-053 Benefit Details ![]() |
$32.50 | $150 | No Gap Coverage | No | Generic: $6.00 Brand: $43.00 Specialty: 29% | 2,852 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 Plus (PDP) - S5960-153 Benefit Details ![]() |
$33.00 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 3,318 Browse Formulary | ||
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Aetna Medicare Rx Plus (PDP) - S5810-225 Sanctioned Plan ![]() |
$35.80 | $0 | No Gap Coverage | No | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $36.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 33% | 3,448 Browse Formulary | ||
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AARP MedicareRx Saver (PDP) - S5921-331 Benefit Details ![]() |
$37.40 | $310 | No Gap Coverage | No | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $25.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $70.50 Tier 4 Specialty: 25% | 3,614 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 | ||||||
Community CCRx Choice (PDP) - S5803-158 Benefit Details ![]() |
$38.20 | $150 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 29% | 2,887 Browse Formulary | ||
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First Health Part D-Secure (PDP) - S5768-103 Benefit Details ![]() |
$39.50 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Generic and Non-Preferred Brand: 59% Specialty - Generic and Brand: 28% | 2,791 Browse Formulary | ||
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AARP MedicareRx Preferred (PDP) - S5820-020 Benefit Details ![]() |
$40.10 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic Brand: $7.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $54.50 Tier 4 Specialty: 33% | 4,916 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 | ||||||
WellCare Signature (PDP) - S5967-055 Benefit Details ![]() |
$40.10 | $0 | No Gap Coverage | tbd | Tier 1: $0.00 Tier 2: $42.00 Tier 3: $85.00 Tier 4: 33% | tbd Browse Formulary | ||
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Medco Medicare Prescription Plan - Choice (PDP) - S5660-021 Benefit Details ![]() |
$40.50 | $100 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $36.00 Non-Preferred Brand: 75% Specialty: 30% | 3,061 Browse Formulary | ||
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Aetna Medicare Rx Essentials (PDP) - S5810-055 Sanctioned Plan ![]() |
$41.40 | $310 | No Gap Coverage | No | Tier 1 Preferred Generic: $2.00 Tier 2 - Non-Preferred Generic: $25.00 Tier 3 - Preferred Brand: $26.00 Tier 4 - Non-Preferred Brand: $70.00 Tier 5 Specialty: 25% | 3,448 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 (PDP) - S5755-059 Benefit Details ![]() |
$42.10 | $160 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty: 25% | 3,092 Browse Formulary | ||
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AdvantraRx Value (PDP) - S5670-111 Benefit Details ![]() |
$42.70 | $100 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: 19% Non-Preferred Generic and Non-Preferred Brand: 62% Specialty - Generic and Brand: 30% | 2,811 Browse Formulary | ||
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EnvisionRxPlus Gold (PDP) - S7694-055 Benefit Details ![]() |
$43.30 | $150 | No Gap Coverage | No | Tier 1 Preferred Generic: $4.00 Tier 2 NonPreferred Generics: $30.00 Tier 3 Preferred Brand: $25.00 Tier 4 NonPreferred Brand: 25% Tier 5 Specialty: 25% | 2,336 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 (PDP) - S5678-047 Benefit Details ![]() |
$44.80 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic : $0.00 Tier 2 Preferred Brand : $42.00 Tier 3 Non-Preferred: $95.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 3,650 Browse Formulary | ||
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Advantage Freedom Plan by RxAmerica (PDP) - S5644-182 Benefit Details ![]() |
$46.10 | $0 | No Gap Coverage | No | Value Generic: $2.50 Generic: $5.00 Preferred Brand: 33% Specialty: 33% Non-Preferred: 45% | 2,626 Browse Formulary | ||
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UA Medicare Part D Prescription Drug Cov (PDP) - S5755-024 Benefit Details ![]() |
$46.50 | $0 | No Gap Coverage | No | Generic: $9.00 Preferred Brand: $38.00 Non-Preferred Brand: $76.00 Specialty: 33% | 3,179 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 | ||||||
Humana Enhanced S5884-019 (PDP) - S5884-019 Benefit Details ![]() |
$47.40 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $41.00 Non-Preferred Brand: $75.00 Specialty: 33% | 4,024 Browse Formulary | ||
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SilverScript CVS Caremark Plus (PDP) - S5601-043 Benefit Details ![]() |
$47.40 | $50 | No Gap Coverage | No | Value Generic Tier: $2.50 Generic Tier: $7.50 Value Brand Tier: $25.00 Preferred Brand Tier: $30.00 Non-Preferred Brand Tier: $90.00 Specialty Tier: 31% | 3,201 Browse Formulary | ||
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RxBLUE (PDP) - S5937-001 Benefit Details ![]() |
$51.50 | $75 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $70.00 Specialty: 31% | 4,786 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 (PDP) - S5670-112 Benefit Details ![]() |
$51.90 | $0 | No Gap Coverage | No | Preferred Generic: $12.00 Preferred Brand: 16% Non-Preferred Generic and Non-Preferred Brand: 50% Specialty - Generic and Brand: 33% | 3,036 Browse Formulary | ||
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Sterling Rx (PDP) - S4802-012 Benefit Details ![]() |
$54.30 | $310 | No Gap Coverage | No | Generic: $8.00 Brand: $29.00 Specialty: 25% | 2,858 Browse Formulary | ||
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CIGNA Medicare Rx Plan Three (PDP) - S5617-191 Benefit Details ![]() |
$59.20 | $0 | Many Generics, Few Brands |
No | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | 3,848 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 CVS Caremark Complete (PDP) - S5601-092 Benefit Details ![]() |
$64.00 | $0 | Many Generics | No | Value Generic Tier: $2.50 Generic Tier: $7.50 Preferred Brand Tier: $39.00 Non-Preferred Brand Tier: $98.00 Specialty Tier: 33% | 3,201 Browse Formulary | ||
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AdvantraRx Premier Plus (PDP) - S5670-114 Benefit Details ![]() |
$64.90 | $0 | Many Generics | No | Preferred Generic: $5.00 Generics: $25.00 Preferred Brand: 18% Non-Preferred Brand: 75% Specialty - Generic and Brand: 33% | 3,036 Browse Formulary | ||
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Community CCRx Gold (PDP) - S5803-238 Benefit Details ![]() |
$68.00 | $0 | All Generics | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,887 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 (PDP) - S5660-191 Benefit Details ![]() |
$75.00 | $0 | Many Generics | No | Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: 75% Specialty: 33% | 3,061 Browse Formulary | ||
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AARP MedicareRx Enhanced (PDP) - S5921-333 Benefit Details ![]() |
$84.10 | $0 | Many Generics | No | Tier 1 Preferred Generic Brand: $7.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $90.00 Tier 4 Specialty: 33% | 4,916 Browse Formulary | ||
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Aetna Medicare Rx Premier (PDP) - S5810-191 Sanctioned Plan ![]() |
$88.00 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $33.00 Tier 3 - Preferred Brand: $34.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 33% | 3,448 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 | ||||||
Humana Complete S5884-049 (PDP) - S5884-049 Benefit Details ![]() |
$98.30 | $0 | Many Generics | No | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty: 33% | 4,024 Browse Formulary | ||
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