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) - S5768-096 Benefit Details |
$22.60 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Generic and Non-Preferred Brand: 51% Specialty - Generic and Brand: 28% | 2,791 Browse Formulary | ||
Aetna Medicare Rx Essentials (PDP) - S5810-048 Sanctioned Plan |
$25.40 | $310 | No Gap Coverage | Yes | Tier 1 Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $26.00 Tier 3 - Preferred Brand: $27.00 Tier 4 - Non-Preferred Brand: $67.00 Tier 5 Specialty: 25% | 3,448 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 Saver (PDP) - S5921-051 Benefit Details |
$26.00 | $310 | No Gap Coverage | Yes | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $25.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $81.75 Tier 4 Specialty: 25% | 3,614 Browse Formulary | ||
Community CCRx Basic (PDP) - S5803-083 Benefit Details |
$27.20 | $310 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 30% Non-Preferred Brand: 50% | 2,887 Browse Formulary | ||
CIGNA Medicare Rx Plan One (PDP) - S5617-068 Benefit Details |
$30.00 | $310 | No Gap Coverage | Yes | Tier 1: $3.00 Tier 2: $34.00 Tier 3: $76.00 Tier 4: 25% | 3,458 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 14 (PDP) - S5932-013 Benefit Details |
$30.30 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,035 Browse Formulary | ||
PrescribaRx Gold (PDP) - S5597-046 Benefit Details |
$30.30 | $150 | No Gap Coverage | No | Generic: $6.00 Brand: $43.00 Specialty: 29% | 2,852 Browse Formulary | ||
BravoRx (PDP) - S5998-011 Benefit Details |
$30.60 | $310 | No Gap Coverage | No | 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 | ||||||
Fox Value Plan (PDP) - S5557-042 Sanctioned Plan |
$30.60 | $310 | No Gap Coverage | No | Tier 1: 0% Tier 2: 50% Tier 3: 40% Tier 4: 60% Tier 5: 25% | 2,826 Browse Formulary | ||
Aetna Medicare Rx Costco Plus Plan (PDP) - S5810-218 Sanctioned Plan |
$31.10 | $0 | No Gap Coverage | No | Tier 1 Preferred Generic: $2.00 Tier 2 - Non-Preferred Generic: $28.00 Tier 3 - Preferred Brand: $34.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 Specialty: 33% | 3,448 Browse Formulary | ||
Health Net Orange Option 1 (PDP) - S5678-034 Benefit Details |
$31.10 | $310 | No Gap Coverage | No | Tier 1 Preferred Generic : $4.00 Tier 2 Preferred Brand : $39.00 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 | ||||||
SilverScript Value (PDP) - S5601-028 Benefit Details |
$31.10 | $310 | No Gap Coverage | No | Generic Tier: $8.00 Preferred Brand Tier: $23.50 Non-Preferred Brand Tier: $95.00 Specialty Tier: 25% | 3,178 Browse Formulary | ||
EnvisionRxPlus Silver (PDP) - S7694-014 Benefit Details |
$31.20 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | 2,318 Browse Formulary | ||
Blue MedicareRx Standard (PDP) - S5596-013 Benefit Details |
$31.60 | $310 | No Gap Coverage | No | 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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
PrescribaRx Bronze (PDP) - S5597-248 Benefit Details |
$31.60 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,852 Browse Formulary | ||
Medco Medicare Prescription Plan - Value (PDP) - S5660-116 Benefit Details |
$32.00 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,061 Browse Formulary | ||
AdvantraRx Value (PDP) - S5670-075 Benefit Details |
$33.30 | $100 | No Gap Coverage | No | Preferred Generic: $7.00 Preferred Brand: 20% Non-Preferred Generic and Non-Preferred Brand: 64% Specialty - Generic and Brand: 30% | 2,811 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 Choice (PDP) - S5803-151 Benefit Details |
$34.20 | $150 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 29% | 2,887 Browse Formulary | ||
First Health Part D-Premier (PDP) - S5768-017 Benefit Details |
$34.70 | $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 | ||
CIGNA Medicare Rx Plan Two (PDP) - S5617-070 Benefit Details |
$35.30 | $100 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $8.00 Tier 3: $40.00 Tier 4: $89.00 Tier 5: 25% | 3,510 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 (PDP) - S5755-052 Benefit Details |
$36.80 | $140 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty: 25% | 3,092 Browse Formulary | ||
WellCare Signature (PDP) - S5967-048 Benefit Details |
$37.00 | $0 | No Gap Coverage | tbd | Tier 1: $0.00 Tier 2: $42.00 Tier 3: $85.00 Tier 4: 33% | tbd Browse Formulary | ||
WellCare Classic (PDP) - S5967-151 Benefit Details |
$38.00 | $310 | No Gap Coverage | tbd | Tier 1: $4.00 Tier 2: $33.00 Tier 3: $70.00 Tier 4: 25% | 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 (PDP) - S5820-013 Benefit Details |
$40.80 | $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: $79.50 Tier 4 Specialty: 33% | 4,916 Browse Formulary | ||
AdvantraRx Premier (PDP) - S5670-076 Benefit Details |
$42.50 | $0 | No Gap Coverage | No | Preferred Generic: $12.00 Preferred Brand: 17% Non-Preferred Generic and Non-Preferred Brand: 54% Specialty - Generic and Brand: 33% | 3,036 Browse Formulary | ||
Humana Enhanced S5884-012 (PDP) - S5884-012 Benefit Details |
$43.20 | $0 | No Gap Coverage | No | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $45.00 Non-Preferred Brand: $75.00 Specialty: 33% | 4,024 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) - S5601-029 Benefit Details |
$43.50 | $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 | ||
Advantage Freedom Plan by RxAmerica (PDP) - S5644-175 Benefit Details |
$45.10 | $0 | No Gap Coverage | No | Value Generic: $2.50 Generic: $5.00 Preferred Brand: 33% Specialty: 33% Non-Preferred: 45% | 2,626 Browse Formulary | ||
Advantage Star Plan by RxAmerica (PDP) - S5644-189 Benefit Details |
$45.70 | $310 | No Gap Coverage | No | Preferred Generic: $4.50 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,629 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 S5884-072 (PDP) - S5884-072 Benefit Details |
$46.40 | $310 | No Gap Coverage | No | Preferred Generic: 15% Non-Preferred Generics/Preferred Brand: 25% Non-Preferred Brand: 44% | 4,008 Browse Formulary | ||
Medco Medicare Prescription Plan - Choice (PDP) - S5660-014 Benefit Details |
$46.70 | $100 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: 75% Specialty: 30% | 3,061 Browse Formulary | ||
Blue MedicareRx Plus (PDP) - S5596-014 Benefit Details |
$47.00 | $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 | ||
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 (PDP) - S5755-017 Benefit Details |
$49.00 | $0 | No Gap Coverage | No | Generic: $7.00 Preferred Brand: $36.00 Non-Preferred Brand: $72.00 Specialty: 33% | 3,179 Browse Formulary | ||
UPMC for Life (PDP) - S8201-001 Benefit Details |
$52.30 | $0 | No Gap Coverage | No | Tier 1 - Generic: $5.00 Tier 2 - Preferred Brand: $32.00 Tier 3 - Non-Preferred Brand: $80.00 Tier 4 - Specialty: 33% | 3,369 Browse Formulary | ||
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Health Net Value Orange Option 2 (PDP) - S5678-033 Benefit Details |
$54.20 | $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 | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
EnvisionRxPlus Gold (PDP) - S7694-048 Benefit Details |
$56.70 | $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 | ||
CIGNA Medicare Rx Plan Three (PDP) - S5617-184 Benefit Details |
$57.70 | $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 | ||
AdvantraRx Premier Plus (PDP) - S5670-078 Benefit Details |
$60.20 | $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 | ||
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) - S5601-085 Benefit Details |
$63.40 | $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 | ||
Sterling Rx (PDP) - S4802-026 Benefit Details |
$70.20 | $310 | No Gap Coverage | No | Generic: $9.00 Brand: $28.00 Specialty: 25% | 2,858 Browse Formulary | ||
Medco Medicare Prescription Plan - Access (PDP) - S5660-184 Benefit Details |
$73.10 | $0 | Many Generics | No | Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: 75% Specialty: 33% | 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 | ||||||
Community CCRx Gold (PDP) - S5803-231 Benefit Details |
$76.30 | $0 | All Generics | No | Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,887 Browse Formulary | ||
AARP MedicareRx Enhanced (PDP) - S5921-053 Benefit Details |
$78.00 | $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 | ||
Aetna Medicare Rx Premier (PDP) - S5810-184 Sanctioned Plan |
$78.00 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $6.00 Tier 2 - Non-Preferred Generic: $36.00 Tier 3 - Preferred Brand: $37.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 33% | 3,448 Browse Formulary | ||
Plan Name | Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Blue MedicareRx Premier (PDP) - S5596-015 Benefit Details |
$94.20 | $0 | Many Generics | 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% | 3,338 Browse Formulary | ||
Humana Complete S5884-042 (PDP) - S5884-042 Benefit Details |
$102.20 | $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 | ||
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