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There are 28 Idaho 2020 stand-alone Medicare Part D plans meeting your criteria.

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2020 Medicare Part D Plan Information
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Plan Name Monthly
Prem.
Deduct-
ible
(Donut Hole)
Additional
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
Humana Walmart Value Rx Plan (PDP) - S5884-210
Benefits & Contact Info
           
$13.20 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: $47.00
Non-Preferred Drug: 35%
Specialty Tier: 25%
3126

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Humana Walmart Value Rx Plan (PDP) - S5884-210 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Walmart Value Rx Plan (PDP) - S5884-210 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Humana Walmart Value Rx Plan (PDP) - S5884-210 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
WellCare Wellness Rx (PDP) - S4802-200
Benefits & Contact Info
           
$14.20 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $40.00
Non-Preferred Drug: 46%
Specialty Tier: 25%
3398

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WellCare Wellness Rx (PDP) - S4802-200 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Wellness Rx (PDP) - S4802-200 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) WellCare Wellness Rx (PDP) - S4802-200 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Clear Spring Health Premier Rx (PDP) - S6946-055
Sanctioned Plan
           
$14.70 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: $40.00
Non-Preferred Drug: 40%
Specialty Tier: 25%
3179

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new new Higher cost-sharing at standard network pharmacies Details:
WellCare Value Script (PDP) - S4802-162
Benefits & Contact Info
           
$17.20 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $6.00
Preferred Brand: $43.00
Non-Preferred Drug: 47%
Specialty Tier: 25%
3398

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WellCare Value Script (PDP) - S4802-162 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Value Script (PDP) - S4802-162 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) WellCare Value Script (PDP) - S4802-162 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
WellCare Medicare Rx Select (PDP) - S5810-307
Benefits & Contact Info
           
$20.90 $425
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $3.00
Preferred Brand: $47.00
Non-Preferred Drug: 42%
Specialty Tier: 25%
3404

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WellCare Medicare Rx Select (PDP) - S5810-307 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Medicare Rx Select (PDP) - S5810-307 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) WellCare Medicare Rx Select (PDP) - S5810-307 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Express Scripts Medicare - Saver (PDP) - S5660-247
Benefits & Contact Info
           
$21.20 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: $30.00
Non-Preferred Drug: 41%
Specialty Tier: 25%
2922

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Express Scripts Medicare - Saver (PDP) - S5660-247 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Express Scripts Medicare - Saver (PDP) - S5660-247 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Express Scripts Medicare - Saver (PDP) - S5660-247 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Cigna-HealthSpring Rx Secure-Essential (PDP) - S5617-310
Benefits & Contact Info
           
$22.20 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $2.00
Preferred Brand: 18%
Non-Preferred Drug: 44%
Specialty Tier: 25%
3100

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Cigna-HealthSpring Rx Secure-Essential (PDP) - S5617-310 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna-HealthSpring Rx Secure-Essential (PDP) - S5617-310 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Cigna-HealthSpring Rx Secure-Essential (PDP) - S5617-310 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Mutual of Omaha Rx Value (PDP) - S7126-063
Benefits & Contact Info
           
$23.90 $435
Tier 1 and 2 exempt
Yes, some additional gap coverage. NoPreferred Generic: $0.00
Generic: $2.00
Preferred Brand: $25.00
Non-Preferred Drug: 44%
Specialty Tier: 25%
2922

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new new Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Clear Spring Health Value Rx (PDP) - S6946-026
Sanctioned Plan
           
$32.70 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: $45.00
Non-Preferred Drug: 36%
Specialty Tier: 25%
3154

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new new Higher cost-sharing at standard network pharmacies Details:
AARP MedicareRx Walgreens (PDP) - S5921-412
Benefits & Contact Info
           
$33.50 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $40.00
Non-Preferred Drug: 32%
Specialty Tier: 25%
3018

Browse Formulary
AARP MedicareRx Walgreens (PDP) - S5921-412 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareRx Walgreens (PDP) - S5921-412 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP MedicareRx Walgreens (PDP) - S5921-412 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
SilverScript Choice (PDP) - S5601-062
Benefits & Contact Info
           
$33.70 $305
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $0.00
Generic: $1.00
Preferred Brand: $47.00
Non-Preferred Drug: 38%
Specialty Tier: 27%
3007

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SilverScript Choice (PDP) - S5601-062 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) SilverScript Choice (PDP) - S5601-062 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) SilverScript Choice (PDP) - S5601-062 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
WellCare Classic (PDP) - S4802-021
Benefits & Contact Info
           
$34.20 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $0.00
Generic: $1.00
Preferred Brand: $31.00
Non-Preferred Drug: 33%
Specialty Tier: 25%
3026

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WellCare Classic (PDP) - S4802-021 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Classic (PDP) - S4802-021 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) WellCare Classic (PDP) - S4802-021 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
AARP MedicareRx Saver Plus (PDP) - S5921-375
Benefits & Contact Info
           
$35.20 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $1.00
Generic: $6.00
Preferred Brand: $27.00
Non-Preferred Drug: 35%
Specialty Tier: 25%
3072

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AARP MedicareRx Saver Plus (PDP) - S5921-375 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareRx Saver Plus (PDP) - S5921-375 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP MedicareRx Saver Plus (PDP) - S5921-375 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Cigna-HealthSpring Rx Secure (PDP) - S5617-153
Benefits & Contact Info
           
$35.20 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $1.00
Generic: $2.00
Preferred Brand: $30.00
Non-Preferred Drug: 35%
Specialty Tier: 25%
Select Care Drugs: $0.00
3124

Browse Formulary
Cigna-HealthSpring Rx Secure (PDP) - S5617-153 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna-HealthSpring Rx Secure (PDP) - S5617-153 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Cigna-HealthSpring Rx Secure (PDP) - S5617-153 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
EnvisionRxPlus (PDP) - S7694-031
Benefits & Contact Info
           
$36.00 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: 15%
Non-Preferred Drug: 26%
Specialty Tier: 25%
3163

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EnvisionRxPlus (PDP) - S7694-031 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) EnvisionRxPlus (PDP) - S7694-031 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) EnvisionRxPlus (PDP) - S7694-031 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Humana Basic Rx Plan (PDP) - S5884-147
Benefits & Contact Info
           
$36.20 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $0.00
Generic: $1.00
Preferred Brand: 25%
Non-Preferred Drug: 39%
Specialty Tier: 25%
3048

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Humana Basic Rx Plan (PDP) - S5884-147 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Basic Rx Plan (PDP) - S5884-147 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Humana Basic Rx Plan (PDP) - S5884-147 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Medicare Rx Saver (PDP) - S5810-065
Benefits & Contact Info
           
$37.00 $435 No additional gap coverage, only the Donut Hole Discount YesPreferred Generic: $0.00
Generic: $2.00
Preferred Brand: $30.00
Non-Preferred Drug: 37%
Specialty Tier: 25%
3124

Browse Formulary
WellCare Medicare Rx Saver (PDP) - S5810-065 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Medicare Rx Saver (PDP) - S5810-065 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) WellCare Medicare Rx Saver (PDP) - S5810-065 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Regence Medicare Script Saver (PDP) - S5916-003
Benefits & Contact Info
           
$38.50 $250
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $3.00
Generic: $10.00
Preferred Brand: $40.00
Non-Preferred Drug: 30%
Specialty Tier: 28%
2893

Browse Formulary
Regence Medicare Script Saver (PDP) - S5916-003 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Regence Medicare Script Saver (PDP) - S5916-003 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Regence Medicare Script Saver (PDP) - S5916-003 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies Details:
Express Scripts Medicare - Value (PDP) - S5660-133
Benefits & Contact Info
           
$39.10 $435 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $3.00
Preferred Brand: $25.00
Non-Preferred Drug: 35%
Specialty Tier: 25%
2998

Browse Formulary
Express Scripts Medicare - Value (PDP) - S5660-133 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Express Scripts Medicare - Value (PDP) - S5660-133 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Express Scripts Medicare - Value (PDP) - S5660-133 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Humana Premier Rx Plan (PDP) - S5884-177
Benefits & Contact Info
           
$51.80 $435
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: $42.00
Non-Preferred Drug: 44%
Specialty Tier: 25%
3207

Browse Formulary
Humana Premier Rx Plan (PDP) - S5884-177 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Premier Rx Plan (PDP) - S5884-177 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Humana Premier Rx Plan (PDP) - S5884-177 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Cigna-HealthSpring Rx Secure-Extra (PDP) - S5617-276
Benefits & Contact Info
           
$56.30 $100
Tier 1, 2, 3 and 6 exempt
Yes, some additional gap coverage. NoPreferred Generic: $4.00
Generic: $10.00
Preferred Brand: $42.00
Non-Preferred Drug: 49%
Specialty Tier: 31%
Select Care Drugs: $2.00
3274

Browse Formulary
Cigna-HealthSpring Rx Secure-Extra (PDP) - S5617-276 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna-HealthSpring Rx Secure-Extra (PDP) - S5617-276 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Cigna-HealthSpring Rx Secure-Extra (PDP) - S5617-276 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Mutual of Omaha Rx Plus (PDP) - S7126-030
Benefits & Contact Info
           
$56.70 $435 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $0.00
Generic: $6.00
Preferred Brand: $42.00
Non-Preferred Drug: 48%
Specialty Tier: 25%
3282

Browse Formulary
new new Higher cost-sharing at standard network pharmacies Details:
WellCare Medicare Rx Value Plus (PDP) - S5768-154
Benefits & Contact Info
           
$70.10 $0 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $1.00
Generic: $4.00
Preferred Brand: $47.00
Non-Preferred Drug: 49%
Specialty Tier: 33%
3404

Browse Formulary
WellCare Medicare Rx Value Plus (PDP) - S5768-154 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Medicare Rx Value Plus (PDP) - S5768-154 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) WellCare Medicare Rx Value Plus (PDP) - S5768-154 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Express Scripts Medicare - Choice (PDP) - S5660-216
Benefits & Contact Info
           
$74.60 $250
Tier 1 and 2 exempt
Yes, some additional gap coverage. NoPreferred Generic: $2.00
Generic: $7.00
Preferred Brand: $42.00
Non-Preferred Drug: 48%
Specialty Tier: 28%
3243

Browse Formulary
Express Scripts Medicare - Choice (PDP) - S5660-216 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Express Scripts Medicare - Choice (PDP) - S5660-216 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Express Scripts Medicare - Choice (PDP) - S5660-216 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
AARP MedicareRx Preferred (PDP) - S5820-030
Benefits & Contact Info
           
$82.90 $0 No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $5.00
Generic: $10.00
Preferred Brand: $45.00
Non-Preferred Drug: 40%
Specialty Tier: 33%
3507

Browse Formulary
AARP MedicareRx Preferred (PDP) - S5820-030 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareRx Preferred (PDP) - S5820-030 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) AARP MedicareRx Preferred (PDP) - S5820-030 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
SilverScript Plus (PDP) - S5601-063
Benefits & Contact Info
           
$84.40 $0 Yes, some additional gap coverage. NoPreferred Generic: $0.00
Generic: $2.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%
3057

Browse Formulary
SilverScript Plus (PDP) - S5601-063 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) SilverScript Plus (PDP) - S5601-063 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) SilverScript Plus (PDP) - S5601-063 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies Details:
Plan Name Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
$0 Prem
LIS?
Preferred Pharmacy
Copay/
Coinsurance
Total Drugs
Service Exper. Cost Info
Regence Medicare Script Basic (PDP) - S5916-001
Benefits & Contact Info
           
$90.00 $250
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole Discount NoPreferred Generic: $3.00
Generic: $10.00
Preferred Brand: $40.00
Non-Preferred Drug: 30%
Specialty Tier: 28%
2671

Browse Formulary
Regence Medicare Script Basic (PDP) - S5916-001 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Regence Medicare Script Basic (PDP) - S5916-001 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Regence Medicare Script Basic (PDP) - S5916-001 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies Details:
Regence Medicare Script Enhanced (PDP) - S5916-002
Benefits & Contact Info
           
$119.00 $0 Yes, some additional gap coverage. NoPreferred Generic: $3.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: 40%
Specialty Tier: 33%
3607

Browse Formulary
Regence Medicare Script Enhanced (PDP) - S5916-002 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Regence Medicare Script Enhanced (PDP) - S5916-002 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Regence Medicare Script Enhanced (PDP) - S5916-002 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
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Chart Legend:

Below are a few notes to help with the understanding of the 2020 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.

  • Plan Name: This is the official plan name from the Centers for Medicare and Medicaid Services (CMS). The same plan name generally has a different plan id in each state. (Search Tip: If you would like to reduce the plans shown to just plans for one or two specific carriers, you can select the carrier name in the "Plan Family" fields 1 and 2. Select the empty (blank) option at the top of the list to remove the criteria. You can also click the "National Plans" checkbox to limit your search to just national plans.)

  • CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.
    This is a 1 to 5 star rating system with five (5) stars as excellent, four (4) stars as very good, three (3) stars as good, two (2) stars as fair and one (1) star as poor.

    • Cust. Service Rating - Drug Plan Customer Service - Medicare and members rate the drug plan and how well a drug plan provides customer service.

      This category includes measures of how drug plans rate on the following areas:
      • Time on Hold When Customer and Pharmacist Calls Drug Plan.
      • Calls Disconnected When Customer and Pharmacist Calls Drug Plan.
      • Drug Plan’s Timeliness in Giving a Decision for Members Who Make an Appeal.
      • Fairness of Drug Plan’s Denials to a Member’s Appeal, Based on an Independent Reviewer.

    • Member Plan Exper. - Member Experience with Drug Plan - This category shows how well drug plans make prescription drugs available to their members.

      This category includes measures of how drug plans rate on the following areas:
      • Drug Plan Provides Information or Help When Members Need It.
      • Members’ Overall Rating of Drug Plan.
      • Members’ Ability to Get Prescriptions Filled Easily When Using the Drug Plan.

    • RxCost Info Rating - This category shows how well drug plans are doing with pricing prescriptions and providing information on the Medicare website.

      This category includes measures of how drug plans rate on the following areas:
      • Completeness of the Drug Plan’s Information on Members Who Need Extra Help.
      • Drug Plan Provides Current Information on Costs and Coverage for Medicare’s Website (the same data is used on this Q1Medicare.com).
      • Drug Plan’s Prices that Did Not Increase More Than Expected During the Year.
      • Drug Plan’s Prices on Medicare’s Website (and this website) Are Similar to the Prices Members Pay at the Pharmacy.
      • Drug Plan’s Members 65 and Older Who Received Prescriptions for Certain Drugs with a High Risk of Side Effects, when There May Be Safer Drug Choices.

  • Monthly Premium: This is the amount you must pay each month to use the plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase. (Search Tip: If you would like to reduce the plans shown to just plans under a certain premium, enter this value in the "Maximum Premium" field.)

    (Search Tip: If you have selected an amount in the "LIS Subsidy Amount" filed, the premium shown is the premium based on your Low-Income Subsidy selection.

  • Deductible: The standard CMS plan initial deductible is $435. Many Medicare plans do not have a deductible, however their plan premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible" field.) Some plans that have an annual deductible exempt certain drug tiers from the deductible. For example, "Tier 1 exempt" may be shown. This would mean that Tier 1 drugs purchased during the Deductible phase, would not fall into the deductible and would be charged the Initial Coverage Phase tier 1 cost-sharing.

  • Gap Coverage (the Donut Hole): In the CMS Standard Plan, the beneficiary, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $5,019 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2020, ALL formulary generics will have at least a 75% discount and ALL brand-name drugs will have at least a 75% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
    • No Gap Coverage: you pay up to $5,019 depending on your mix of generics and brand-name drugs. Read more...
    • Yes: This plan offers some level of gap coverage. See plan details for a description of the gap coverage. It will read similar to: Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.

  • $0 Premium with Full LIS - Does the plan qualify for $0 premium with full Low-Income Subsidy?: If Yes is in the field, then you would pay a $0 premium if you have a Full Low-Income Subsidy (LIS). If No is in the field, then you would be responsible for the difference between what the state provides as the Full Low-Income Subsidy and the actual cost of the plan even if you have a Full Low-Income Subsidy. (Search Tip: If you would like to reduce the plans shown to just plans that qualify for the $0 premium (Benchmark plans), select "Yes..." in the "Full Low-Income Subsidy?" field.)

  • Plan ID: This is the unique id for this particular plan.

  • Copay / Coinsurance - Cost Sharing - This is what you will pay for formulary drugs in the Initial Coverage Phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. Plans can form their own tiers, so you should contact the plan or reference their summary of benefits to find out what copays and limitations are associated with each tier. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the "Max. Co-pay Tier 1 (Generics)" field.)

Additional Information Fields:
You can select one of the following additional pieces of plan information to display (Search Tip: to change the type of information shown in the last column of the chart, select the data to be shown in the "Additional Info" field.)
  • Total Formulary Drugs (default) - This is the total number of medications on the plans formulary or drug list. This total drug count does not include "Bonus Drugs". These are non-Medicare Part D drugs which are covered by the plan, however they do not count toward your plan deductible, retail drug cost, or TrOOP.

  • Plan’s Summary Star Rating - This is the overall star rating for the Medicare Part D plan. To learn more about the star ratings, please see our Plan Quality Star Ratings.

  • Offers Mail Order - "Yes" is displayed if this plan offers mail order on any medications. It does NOT mean that ALL medications are available through mail order.

  • Members in This State (updated: February 2020 figures) - This is the total number of members in this plan for this PDP CMS Region. For regions that contain more than one state, this is the total for all of those states combined. If the CMS Region contains more than one state, the actual state enrollment is shown, along with the CMS region and national enrollment figures on the plan details page. you can access the plan details by clicking the plan name, orange enroll options button, or the plan details icon.

  • Members Nation Wide (updated: February 2020 figures) - This is the total number of member for this plan in all CMS Regions (States) combined.

  • Initial Coverage Limit (ICL) - The Initial Coverage Phase of a Medicare Part D plan is the phase AFTER the initial deductible is met (if the plan has an initial deductible) and BEFORE the coverage gap (or donut hole) begins. The ICL is the phase of the prescription drug plan during which you and your plan share your prescription costs. During this phase you will pay either a co-payment (a flat fee per prescription) or co-insurance (a percentage of the drug cost). The details of the cost-sharing for the plan are shown in the Cost-Sharing column directly to the left of this column. The CMS standard Initial Coverage Limit for 2020 is $4,020 and increases each year.

  • National or Regional Plans - This column simply displays the word "National" if the plan is sponsored by a national carrier or "Regional" if the plan sponsor is a regional carrier.



(Chart Source: various files provided by the Centers for Medicare and Medicaid Services along with data from the Medicare.gov website plan finder.)

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Medicare plan provider.