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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Aetna Medicare Rx Essentials (PDP) - S5810-056 Sanctioned Plan |
$21.00 | $310 | No Gap Coverage | Yes | Tier 1 Preferred Generic: $1.00 Tier 2 - Non-Preferred Generic: $24.00 Tier 3 - Preferred Brand: $29.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 Specialty: 25% | 3,448 Browse Formulary | ||
PrescribaRx Bronze (PDP) - S5597-256 Benefit Details |
$23.20 | $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 | ||||||
AARP MedicareRx Saver (PDP) - S5921-191 Benefit Details |
$23.50 | $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: $80.00 Tier 4 Specialty: 25% | 3,614 Browse Formulary | ||
UnitedHealthcare MedicareRx (PDP) - S5917-001 Benefit Details |
$23.50 | $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: $70.00 Tier 4 Specialty: 25% | 3,212 Browse Formulary | ||
WellCare Classic (PDP) - S5967-159 Benefit Details |
$24.50 | $310 | No Gap Coverage | tbd | Tier 1: $4.00 Tier 2: $37.00 Tier 3: $75.00 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 | ||||||
First Health Part D-Premier (PDP) - S5768-045 Benefit Details |
$24.80 | $150 | No Gap Coverage | Yes | Preferred Generic: $8.00 Preferred Brand: 12% Non-Preferred Generic/Non-Preferred Brand: 44% Specialty - Generic and Brand: 29% | 3,031 Browse Formulary | ||
CIGNA Medicare Rx Plan One (PDP) - S5617-108 Benefit Details |
$25.00 | $310 | No Gap Coverage | Yes | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $77.00 Tier 4: 25% | 3,458 Browse Formulary | ||
HealthSpring Prescription Drug Plan-Reg 22 (PDP) - S5932-021 Benefit Details |
$25.40 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% | 3,035 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 Basic (PDP) - S5803-091 Benefit Details |
$25.70 | $310 | No Gap Coverage | Yes | Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 70% | 2,887 Browse Formulary | ||
EnvisionRxPlus Silver (PDP) - S7694-022 Benefit Details |
$25.70 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | 2,318 Browse Formulary | ||
Aetna Medicare Rx Plus (PDP) - S5810-226 Sanctioned Plan |
$25.80 | $0 | No Gap Coverage | No | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $38.00 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 | ||||||
BravoRx (PDP) - S5998-039 Benefit Details |
$26.70 | $310 | No Gap Coverage | Yes | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 2,912 Browse Formulary | ||
Humana Basic S5884-121 (PDP) - S5884-121 Benefit Details |
$27.90 | $310 | No Gap Coverage | No | Preferred Generic: $4.00 Non-Preferred Generics/Preferred Brand: 29% Non-Preferred Brand: 29% | 3,041 Browse Formulary | ||
MedicareRx Rewards Standard (PDP) - S5960-128 Benefit Details |
$28.30 | $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 | ||||||
Advantage Star Plan by RxAmerica (PDP) - S5644-079 Benefit Details |
$29.40 | $310 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: 25% Specialty: 25% Non-Preferred: 45% | 2,629 Browse Formulary | ||
Health Net Orange Option 1 (PDP) - S5678-050 Benefit Details |
$29.40 | $310 | No Gap Coverage | No | 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 | ||
SilverScript Value (PDP) - S5601-044 Benefit Details |
$29.40 | $310 | No Gap Coverage | No | Generic Tier: $8.00 Preferred Brand Tier: $22.50 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 | ||||||
Blue MedicareRx - Value (PDP) - S5715-005 Benefit Details |
$33.30 | $0 | No Gap Coverage | No | Generic: $11.00 Preferred Brand: $45.00 Brand: $88.00 Specialty: 33% | 2,676 Browse Formulary | ||
UA Medicare Part D Rx Covg - Silver Plan (PDP) - S5755-060 Benefit Details |
$34.30 | $140 | No Gap Coverage | No | Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty: 25% | 3,092 Browse Formulary | ||
CIGNA Medicare Rx Plan Two (PDP) - S5617-110 Benefit Details |
$34.40 | $100 | No Gap Coverage | No | Tier 1: $0.00 Tier 2: $8.00 Tier 3: $37.00 Tier 4: $93.00 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 | ||||||
WellCare Signature (PDP) - S5967-056 Benefit Details |
$37.10 | $0 | No Gap Coverage | tbd | Tier 1: $0.00 Tier 2: $42.00 Tier 3: $85.00 Tier 4: 33% | tbd Browse Formulary | ||
PrescribaRx Gold (PDP) - S5597-054 Benefit Details |
$37.80 | $150 | No Gap Coverage | No | Generic: $6.00 Brand: $43.00 Specialty: 29% | 2,852 Browse Formulary | ||
Blue MedicareRx - Standard (PDP) - S5715-009 Benefit Details |
$39.00 | $310 | No Gap Coverage | No | Generic: $3.00 Preferred Brand: $33.00 Brand: $83.00 Specialty: 25% | 2,676 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) - S5820-021 Benefit Details |
$41.00 | $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: $64.00 Tier 4 Specialty: 33% | 4,916 Browse Formulary | ||
Humana Enhanced S5884-020 (PDP) - S5884-020 Benefit Details |
$41.40 | $0 | No Gap Coverage | No | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 4,024 Browse Formulary | ||
AdvantraRx Value (PDP) - S5670-117 Benefit Details |
$41.80 | $100 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: 19% 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) - S5803-159 Benefit Details |
$42.20 | $150 | No Gap Coverage | No | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 29% | 2,887 Browse Formulary | ||
Scott and White Health Plan Texas Rx Value (PDP) - S5915-003 Benefit Details |
$44.50 | $310 | No Gap Coverage | No | Preferred Generic: $1.00 Preferred Brand: $29.00 Non-Preferred Brand or Generic: $60.00 | 2,535 Browse Formulary | ||
MedicareRx Rewards Plus (PDP) - S5960-154 Benefit Details |
$46.30 | $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 | ||||||
Scott and White Health Plan Texas Rx Basic (PDP) - S5915-004 Benefit Details |
$46.40 | $0 | No Gap Coverage | No | Preferred Generic: $6.00 Preferred Brand: $35.00 Non-Preferred Brand or Generic: $65.00 Specialty: 33% | 2,536 Browse Formulary | ||
First Health Part D-Secure (PDP) - S5768-104 Benefit Details |
$47.20 | $175 | No Gap Coverage | No | Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Generic and Non-Preferred Brand: 53% Specialty - Generic and Brand: 28% | 2,791 Browse Formulary | ||
Medco Medicare Prescription Plan - Value (PDP) - S5660-124 Benefit Details |
$47.70 | $310 | No Gap Coverage | No | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 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 | ||||||
Medco Medicare Prescription Plan - Choice (PDP) - S5660-022 Benefit Details |
$49.80 | $100 | No Gap Coverage | No | Generic: $6.00 Preferred Brand: $39.00 Non-Preferred Brand: 75% Specialty: 30% | 3,061 Browse Formulary | ||
UA Medicare Part D Prescription Drug Cov (PDP) - S5755-025 Benefit Details |
$50.70 | $0 | No Gap Coverage | No | Generic: $9.00 Preferred Brand: $38.00 Non-Preferred Brand: $76.00 Specialty: 33% | 3,179 Browse Formulary | ||
AdvantraRx Premier (PDP) - S5670-118 Benefit Details |
$51.90 | $0 | No Gap Coverage | No | Preferred Generic: $12.00 Preferred Brand: 16% Non-Preferred Generic and Non-Preferred Brand: 52% 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 | ||||||
Advantage Freedom Plan by RxAmerica (PDP) - S5644-058 Benefit Details |
$54.30 | $0 | No Gap Coverage | No | Value Generic: $2.50 Generic: $5.00 Preferred Brand: 33% Specialty: 33% Non-Preferred: 45% | 2,626 Browse Formulary | ||
SilverScript CVS Caremark Plus (PDP) - S5601-045 Benefit Details |
$60.70 | $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 | ||
Sterling Rx (PDP) - S4802-013 Benefit Details |
$61.40 | $310 | No Gap Coverage | No | Generic: $9.00 Brand: $29.00 Specialty: 25% | 2,858 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) - S7694-056 Benefit Details |
$63.40 | $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 | ||
Health Net Orange Option 2 (PDP) - S5678-049 Benefit Details |
$66.40 | $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 | ||
CIGNA Medicare Rx Plan Three (PDP) - S5617-192 Benefit Details |
$66.50 | $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 | ||||||
Blue MedicareRx - Plus (PDP) - S5715-006 Benefit Details |
$67.50 | $0 | Many Generics | No | Generic: $5.00 Preferred Brand: $38.00 Brand: $75.00 Specialty: 33% | 2,676 Browse Formulary | ||
AdvantraRx Premier Plus (PDP) - S5670-120 Benefit Details |
$68.80 | $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 | ||
Aetna Medicare Rx Premier (PDP) - S5810-192 Sanctioned Plan |
$74.80 | $0 | Many Generics | No | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $34.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - Non-Preferred Brand: $81.00 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 | ||||||
Community CCRx Gold (PDP) - S5803-239 Benefit Details |
$75.70 | $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) - S5921-193 Benefit Details |
$76.20 | $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 | ||
SilverScript CVS Caremark Complete (PDP) - S5601-093 Benefit Details |
$81.90 | $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 | ||
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) - S5660-192 Benefit Details |
$86.00 | $0 | Many Generics | No | Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: 75% Specialty: 33% | 3,061 Browse Formulary | ||
Humana Complete S5884-050 (PDP) - S5884-050 Benefit Details |
$94.90 | $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 | ||
Scott and White Health PlanTexas Rx Enhanced (PDP) - S5915-002 Benefit Details |
$113.40 | $0 | Many Generics | No | Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand or Generic: $65.00 Specialty: 33% | 2,536 Browse Formulary | ||
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