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2024 Medicare Prescription Drug Plan Benefit Details for the Cigna Secure Rx (PDP)
2024 Medicare Prescription Drug Plan Details
Medicare Plan Name:Cigna Secure Rx (PDP)
   by Cigna
State:Wyoming
Plan ID:S5617 - 123 - 0     Click to see other plans
Member Services:1-800-222-6700 TTY users 711
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 Cigna Secure Rx (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$59.20 (see Plan Premium Details below)
Annual Deductible:$545
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium. (See premium for LIS subsidy beneficiaries below.)
Annual Initial Coverage Limit (ICL):$5,030
Drug Benefit Type ❔Actuarially Equivalent Standard (AE)
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,276 drugsBrowse the Cigna Secure Rx (PDP) Formulary
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. 
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$0.00$3.0016%47%25%
• Number of Drugs per
  Tier:		2034926851314582
Plan Offers Mail Order?Yes
Medicare Plan Pharmacy Numbers: BIN: 017010   PCN: CIMCARE   See BIN/PCNs for all plans
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in Wyoming:372 members
Number of Members enrolled in this plan in your CMS Region:4,317 members     (CMS Region 25)
Number of Members enrolled in this plan nationally:821,849 members
Plan’s Summary Star Rating: 2.5 out of 5 Stars.
• Customer Service Rating: 1 out of 5 Stars.
• Member Experience Rating: 3 out of 5 Stars.
• Drug Cost Accuracy Rating: 3 out of 5 Stars.
— Plan Premium Details —
The Monthly Premium is Split as Follows: ❔
Total
Premium		Part D Basic
Premium		Part D Supplemental
Premium
$59.20$59.20$0.00
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ $17.00




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