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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First Health Part D-Secure (PDP) - S5569-005 Benefit Details |
$19.50 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Generic and Non-Preferred Brand: 49% Specialty - Generic and Brand: 28% | 2,791 Browse Formulary | ||
GHI Medicare Prescription Drug Plan (PDP) - S5966-001 Benefit Details |
$27.60 | $310 | No Gap Coverage | Yes | Tier #1: $5.00 Tier #2: 25% Tier #3: 40% Tier #4: 25% | 4,852 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 (PDP) - S5617-013 Benefit Details |
$27.70 | $310 | No Gap Coverage | Yes | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $74.00 Tier 4: 25% | 3,458 Browse Formulary | ||
Medco Medicare Prescription Plan - Value (PDP) - S5983-004 Benefit Details |
$28.00 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 3,061 Browse Formulary | ||
PrescribaRx Bronze (PDP) - S5825-045 Benefit Details |
$28.30 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,852 Browse Formulary | ||
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) - S5644-004 Benefit Details |
$28.80 | $310 | No Gap Coverage | Yes | Preferred Generic: $5.00 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,629 Browse Formulary | ||
Fox Value Plan (PDP) - S5557-034 Sanctioned Plan |
$29.30 | $310 | No Gap Coverage | Yes | Tier 1: 0% Tier 2: 50% Tier 3: 35% Tier 4: 60% Tier 5: 25% | 2,857 Browse Formulary | ||
BravoRx (PDP) - S5998-001 Benefit Details |
$30.60 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,912 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
HIP Part D New York (PDP) - S5741-001 Benefit Details |
$30.60 | $310 | No Gap Coverage | Yes | Tier #1: $4.00 Tier #2: 25% Tier #3: 40% Tier #4: 25% | 4,852 Browse Formulary | ||
EnvisionRxPlus Silver (PDP) - S7694-003 Benefit Details |
$31.20 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | 2,318 Browse Formulary | ||
SilverScript Value (PDP) - S5601-006 Benefit Details |
$31.60 | $310 | No Gap Coverage | Yes | Generic Tier: $8.00 Preferred Brand Tier: $23.50 Non-Preferred Brand Tier: $95.00 Specialty Tier: 25% | 3,178 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) - S5967-140 Benefit Details |
$33.30 | $310 | No Gap Coverage | tbd | Tier 1: $4.00 Tier 2: $36.00 Tier 3: $75.00 Tier 4: 25% | tbd Browse Formulary | ||
Community CCRx Basic (PDP) - S5803-072 Benefit Details |
$33.40 | $310 | No Gap Coverage | No | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 60% | 2,887 Browse Formulary | ||
SmartHealth RX PDP (PDP) - S5585-001 Benefit Details |
$35.50 | $100 | No Gap Coverage | No | Formulary Generics: $6.00 Formulary Brands: $40.00 Non Preferred Generic/Brand : 40% Specialty Injectables: 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 | ||||||
Advantage Freedom Plan by RxAmerica (PDP) - S5644-048 Benefit Details |
$35.70 | $0 | No Gap Coverage | No | Value Generic: $2.50 Generic: $5.00 Preferred Brand: 33% Specialty: 33% Non-Preferred: 45% | 2,626 Browse Formulary | ||
Community CCRx Choice (PDP) - S5803-140 Benefit Details |
$36.20 | $150 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 29% | 2,887 Browse Formulary | ||
AARP MedicareRx Saver (PDP) - S5921-203 Benefit Details |
$36.40 | $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: $93.00 Tier 4 Specialty: 25% | 3,614 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 (PDP) - S5678-003 Benefit Details |
$37.10 | $310 | No Gap Coverage | No | Tier 1 Preferred Generic : $4.00 Tier 2 Preferred Brand : $35.00 Tier 3 Non-Preferred: $95.00 Tier 4 Injectable: 25% Tier 5 Specialty: 25% | 3,650 Browse Formulary | ||
AARP MedicareRx Preferred (PDP) - S5805-001 Benefit Details |
$37.40 | $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: $71.25 Tier 4 Specialty: 33% | 4,916 Browse Formulary | ||
PrescribaRx Gold (PDP) - S5825-017 Benefit Details |
$37.60 | $150 | No Gap Coverage | No | Generic: $6.00 Brand: $43.00 Specialty: 29% | 2,852 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 (PDP) - S5569-003 Benefit Details |
$38.20 | $150 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: 11% Non-Preferred Generic/Non-Preferred Brand: 44% Specialty - Generic and Brand: 29% | 3,031 Browse Formulary | ||
First UA Medicare Part D Rx Covg - Silver (PDP) - S5580-004 Benefit Details |
$38.20 | $160 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty: 25% | 3,092 Browse Formulary | ||
MedicareRx Rewards Standard (PDP) - S5960-109 Benefit Details |
$38.70 | $310 | No Gap Coverage | No | 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 | ||
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 Two (PDP) - S5617-015 Benefit Details |
$40.80 | $100 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $8.00 Tier 3: $37.00 Tier 4: $90.00 Tier 5: 25% | 3,510 Browse Formulary | ||
HealthSpring Prescription Drug Plan -Reg 3 (PDP) - S5932-004 Benefit Details |
$41.10 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% | 3,035 Browse Formulary | ||
WellCare Signature (PDP) - S5967-037 Benefit Details |
$41.60 | $0 | No Gap Coverage | tbd | Tier 1: $0.00 Tier 2: $42.00 Tier 3: $85.00 Tier 4: 33% | tbd 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 Costco Plus Plan (PDP) - S5810-207 Sanctioned Plan |
$42.00 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic: $2.00 Tier 2 - Non-Preferred Generic: $29.00 Tier 3 - Preferred Brand: $32.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 Specialty: 33% | 3,448 Browse Formulary | ||
Humana Enhanced S5552-001 (PDP) - S5552-001 Benefit Details |
$42.70 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $45.00 Non-Preferred Brand: 41% | 3,041 Browse Formulary | ||
Simply Prescriptions Rx 1 (PDP) - S3521-001 Benefit Details |
$43.70 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,927 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
First UA Medicare Part D Prescription Drug (PDP) - S5580-003 Benefit Details |
$46.00 | $0 | No Gap Coverage | No | Generic: $10.00 Preferred Brand: $39.00 Non-Preferred Brand: $78.00 Specialty: 33% | 3,179 Browse Formulary | ||
AdvantraRx Value (PDP) - S0197-002 Benefit Details |
$47.10 | $100 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: 20% Non-Preferred Generic and Non-Preferred Brand: 65% Specialty - Generic and Brand: 30% | 2,811 Browse Formulary | ||
Medco Medicare Prescription Plan - Choice (PDP) - S5983-001 Benefit Details |
$47.20 | $100 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $39.00 Non-Preferred Brand: 75% Specialty: 30% | 3,061 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 (PDP) - S5810-037 Sanctioned Plan |
$50.00 | $310 | No Gap Coverage | No | Tier 1 Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $24.00 Tier 3 - Preferred Brand: $25.00 Tier 4 - Non-Preferred Brand: $67.00 Tier 5 Specialty: 25% | 3,448 Browse Formulary | ||
EnvisionRxPlus Gold (PDP) - S7694-037 Benefit Details |
$51.10 | $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 | ||
MedicareRx Rewards Plus (PDP) - S5960-141 Benefit Details |
$51.40 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
SilverScript CVS Caremark Plus (PDP) - S5601-007 Benefit Details |
$51.40 | $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 | ||
Simply Prescriptions Rx 3 (PDP) - S3521-003 Benefit Details |
$57.00 | $100 | No Gap Coverage | No | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 25% | 4,805 Browse Formulary | ||
AdvantraRx Premier (PDP) - S0197-003 Benefit Details |
$57.40 | $0 | No Gap Coverage | No | Preferred Generic: $13.00 Preferred Brand: 19% Non-Preferred Generic and Brand: 50% Specialty - Generic and Brand: 33% | 3,036 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Humana Standard S5552-003 (PDP) - S5552-003 Benefit Details |
$59.90 | $310 | No Gap Coverage | No | Preferred Generic: 15% Non-Preferred Generic/Preferred Brand: 25% Non-Preferred Brand: 38% | 4,008 Browse Formulary | ||
Sterling Rx (PDP) - S4802-024 Benefit Details |
$64.90 | $310 | No Gap Coverage | No | Generic: $9.00 Brand: $30.00 Specialty: 25% | 2,858 Browse Formulary | ||
Health Net Orange Option 2 (PDP) - S5678-009 Benefit Details |
$65.80 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic : $5.00 Tier 2 Preferred Brand : $35.00 Tier 3 Non-Preferred: $95.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 4,876 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 (PDP) - S0197-005 Benefit Details |
$67.20 | $0 | Many Generics | No | Preferred Generic: $5.00 Generics: $25.00 Preferred Brand: 20% Non-Preferred Brand: 75% Specialty - Generic and Brand: 33% | 3,036 Browse Formulary | ||
HIP Enhanced Part D New York (PDP) - S5741-003 Benefit Details |
$68.60 | $0 | Many Generics | No | Tier #1: $5.00 Tier #2: $25.00 Tier #3: 40% Tier #4: 25% | 4,852 Browse Formulary | ||
CIGNA Medicare Rx Plan Three (PDP) - S5617-173 Benefit Details |
$71.00 | $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 | ||
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) - S5601-074 Benefit Details |
$76.70 | $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 | ||
Medco Medicare Prescription Plan - Access (PDP) - S5983-005 Benefit Details |
$77.80 | $0 | Many Generics | No | Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: 75% Specialty: 33% | 3,061 Browse Formulary | ||
AARP MedicareRx Enhanced (PDP) - S5921-213 Benefit Details |
$80.10 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Community CCRx Gold (PDP) - S5825-085 Benefit Details |
$81.00 | $0 | All Generics | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,887 Browse Formulary | ||
Humana Complete S5552-002 (PDP) - S5552-002 Benefit Details |
$105.50 | $0 | Many Generics | No | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $45.00 Non-Preferred Brand: $75.00 Specialty: 33% | 4,024 Browse Formulary | ||
Aetna Medicare Rx Premier (PDP) - S5810-173 Sanctioned Plan |
$117.50 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $37.00 Tier 3 - Preferred Brand: $38.00 Tier 4 - Non-Preferred Brand: $88.00 Tier 5 - Specialty: 33% | 3,448 Browse Formulary | ||
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