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2010 Medicare Prescription Drug Plan Benefit Details for the PrescribaRx Gold (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2010 Medicare Prescription Drug Plan Details
Medicare Plan Name:PrescribaRx Gold (PDP)
   by Universal American
State:Washington DC
Plan ID:S5597 - 037 - 0     Click to see other plans
Member Services:1-800-818-0007 TTY users 1-800-958-2692
— This plan information is for research purposes only. —
Click here to see plans for the current plan year
Medicare Contact Information:Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.
TTY users 1-877-486-2048
or contact your local SHIP for assistance
Email a copy of the PrescribaRx Gold (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$39.80
Annual Deductible:$150
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,830
Drug Benefit Type ❔Enhanced Alternative (EA)
Gap Coverage?No Gap Coverage
Total Number of Formulary Drugs:2,852 drugsBrowse the PrescribaRx Gold (PDP) Formulary
This plan has 3 drug tiers. See cost-sharing highlights below.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$6.00$43.0029%  
• Number of Drugs per
  Tier:		1644953255
Plan Offers Mail Order?Yes
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in your CMS Region:862 members     (CMS Region 05)
Number of Members enrolled in this plan nationally:46,200 members




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