Personal Choice 65 Achieve Rx (PPO)
Available to residents of Delaware County, PA for 2026. Contract H3909, plan 020, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $375.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H3909-020-0 |
| Offered by | Independence Blue Cross |
| Parent organization | Independence Health Group, Inc. |
| Formulary drugs | 3,432 |
CMS star ratings
- Overall
- 4 out of 5 stars for Overall
- Health plan (Part C)
- 4 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H3909 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | 25% |
| Tier 4 | 30% |
| Tier 5 | 28% |
Also available in 4 other PA counties
Plan facts come from the CMS quarterly prescription drug plan public use files.