| 2012 Medicare Part D Plan Details |
 |
|
| Plan Name: | Community CCRx Choice (PDP)
by Community CCRx PDP |
| State: | New Hampshire |
| Plan ID: | S5803 - 138 Click to see other plans |
|
|
Click here for the Community CCRx Choice (PDP) enrollment options and to have a copy of this chart sent to your email.
|
| Plan Materials for New Hampshire: | Click here to jump to plan materials (Formulary, Summary of Benefits, etc.) |
|
| — Plan Features — |
| Monthly Premium: | $90.10 |
| Annual Deductible: | $0 |
| $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: | 3019 Browse Plan Formulary |
| Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
— Cost-Sharing during
initial coverage phase: | $0.00 | $40.00 | $70.00 | 33% | |
| — Number of Drugs per Tier: | 1399 | 779 | 521 | 320 | 0 |
| Plan Offers Mail Order: | Yes |
| Plan Type (Reach): | National Plan |
| Number of Members enrolled in this plan in your CMS Region: | 338 |
| Number of Members enrolled in this plan nationally: | 115,900 |
| Plan’s Summary Star Rating: | 3.00 out of 5 Stars. |
| - Customer Service Rating: | 3 out of 5 Stars. |
| - Member Experience Rating: | 4 out of 5 Stars. |
| - Drug Cost Accuracy Rating: | 3 out of 5 Stars. |
