| 2012 Medicare Part D Plan Details |
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| Plan Name: | Blue MedicareRx Standard (PDP)
by Anthem Blue Cross and Blue Shield |
| State: | New Hampshire |
| Plan ID: | S5596 - 046 Click to see other plans |
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Click here for the Blue MedicareRx Standard (PDP) enrollment options and to have a copy of this chart sent to your email.
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| Plan Materials for New Hampshire: | Click here to jump to plan materials (Formulary, Summary of Benefits, etc.) |
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| — Plan Features — |
| Monthly Premium: | $32.80 |
| Annual Deductible: | $320 |
| $0 Premium if Full LIS Benefits: | No, this plan does NOT qualify for the $0 Premium. |
| Initial Coverage Limit (ICL): | $2,930 |
| Gap Coverage: | No Gap Coverage |
| Total Number of Formulary Drugs: | 3212 Browse Plan Formulary |
| Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
— Cost-Sharing during
initial coverage phase: | $4.00 | $7.00 | $45.00 | $90.00 | 25% |
| — Number of Drugs per Tier: | 407 | 1221 | 410 | 231 | 539 |
| Plan Offers Mail Order: | Yes |
| Plan Type (Reach): | Regional Plan |
| Number of Members enrolled in this plan in your CMS Region: | 2,294 |
| Number of Members enrolled in this plan nationally: | 95,596 |
| Plan’s Summary Star Rating: | 2.50 out of 5 Stars. |
| - Customer Service Rating: | 2 out of 5 Stars. |
| - Member Experience Rating: | 2 out of 5 Stars. |
| - Drug Cost Accuracy Rating: | 3 out of 5 Stars. |
