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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UnitedHealthcare MedicareRx (PDP) - S5917-029 Benefit Details |
$10.30 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,212 Browse Formulary | ||
Health Net Orange Option 1 (PDP) - S5678-001 Benefit Details |
$17.00 | $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 | ||
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) - S5960-134 Benefit Details |
$17.60 | $310 | No Gap Coverage | Yes | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: 25% Tier 3 Non-Specialty Injectable Drugs: 25% Tier 4 Specialty Drugs: 25% | 3,251 Browse Formulary | ||
Humana Basic S5884-124 (PDP) - S5884-124 Benefit Details |
$17.70 | $310 | No Gap Coverage | Yes | Preferred Generic: $4.00 Non-Preferred Generics/Preferred Brand: 29% Non-Preferred Brand: 29% | 3,041 Browse Formulary | ||
Fox Value Plan (PDP) - S5557-004 Sanctioned Plan |
$19.60 | $310 | No Gap Coverage | Yes | Tier 1: 0% Tier 2: 50% Tier 3: 40% Tier 4: 60% Tier 5: 25% | 2,826 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 (PDP) - S5967-165 Benefit Details |
$19.70 | $310 | No Gap Coverage | tbd | Tier 1: $4.00 Tier 2: $36.00 Tier 3: $75.00 Tier 4: 25% | tbd Browse Formulary | ||
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