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: : Compare 2013 Medicare Rx and Health Plans by Drug Costs
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2012 Drug Finder:
Search for Your Prescription Drug Across All Medicare Part D or Medicare Advantage Plans


There are three ways to find your medication:
  1. Select your State and enter at least the first three letters of your drug name.
  2. Select your State and enter your drug’s 11-digit National Drug Code (NDC).
  3. Select the starting letter for the drug you wish to find. You will be taken to a page showing all Medicare Part D drugs beginning with this letter. Click on the medication. You will return to this page. Select your State (if not already shown).
All Medicare Part D plans or Medicare Advantage Plans with prescription drug coverage that cover this drug will be shown with the plan’s premium, deductible, and drug cost-sharing details. Example: All California Medicare Part D plans covering LIPITOR 10MG.

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Search Criteria
PlanType:* PDP     MAPD
State:*
Selected Drug:*ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) (100 BOT)
Drug Name: Ex: Lipitor
Browse Drugs by Alphabet:   A  B  C  D  E  F  G  H  I  J  K  L  M
  N  O  P  Q  R  S  T  U  V  W  X  Y  Z 
Natl Drug Code (NDC):     Ex: 00071015694
Plan Family 1:
Plan Family 2:
Maximum Premium:  $ max: $132
Maximum Deductible:  $ max: $320
Type of Gap Coverage:
Full Low-Income Subsidy?
Drug (Usage) Utilization Management Options:
   Requires Prior Authorization: Yes No Show either (default)
   Uses Step Therapy:                 Yes No Show either (default)
   Has Quantity Limits:                Yes No Show either (default)
Sort Results by:
Search Criteria Options: Basic     Advanced
  *required.
  
: :Go to OH’s 2012 Plan Page for plan materials
: :Print Version
: :2012 Plan Finder
: :Compare 2011 & 2012 Plans
: :Create a Medicine Cabinet & Compare Select Plans

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: : Link to This Chart                         
There are 32 Stand-Alone 2012 Medicare Part D plans available in OH that meet your criteria.
Click below to access enrollment options (including download, online, and telephone).
Drug: ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) (100 BOT) (NDC: 00591578201)
2012 Medicare Part D Plan Information
Click here to jump to the Chart Legend
Plan Name Monthly
Prem.
De- duct-
ible
Gap
Coverage
Plan
ID
Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.
Tier
Description
30-Day
Prfrd.
Pharm
90-Day
Mail
Order
Humana Walmart-Preferred Rx Plan (PDP)
$15.10 $320 No Gap Coverage S5884
-137
1 Preferred Generic Drugs $1.00 $0.00 None
Browse Plan Formulary
First Health Part D Value Plus (PDP)
$25.10 $0 No Gap Coverage S5768
-137
1 Preferred Generic Drugs $0.00 N/A None
Browse Plan Formulary
Aetna CVS/pharmacy Prescription Drug Plan (PDP)
$26.00 $320 No Gap Coverage S5810
-048
1 Preferred generic drugs $3.00 $9.00 None
Browse Plan Formulary
Community CCRx Basic (PDP)
$26.90 $320 No Gap Coverage S5803
-083
1 Generic Drugs $2.00 N/A None
Browse Plan Formulary
CVS Caremark Value (PDP)
$27.70 $320 No Gap Coverage S5601
-028
1 Generic Drugs $5.50 $8.25 None
Browse Plan Formulary
Plan Name Monthly
Prem.
De- duct-
ible
Gap
Coverage
Plan
ID
Tier
Nbr.
Tier
Description
30-Day
Prfd.
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
United American - Select (PDP)
$29.10 $320 No Gap Coverage S5755
-085
1 Preferred Generic Drugs $2.00 $0.00 None
Browse Plan Formulary
HealthSpring Prescription Drug Plan-Reg 14 (PDP)
$29.70 $320 No Gap Coverage S5932
-013
1 Tier 1 25% 25% None
Browse Plan Formulary
WellCare Classic (PDP)
$30.40 $320 No Gap Coverage S5967
-151
1 Preferred Generic Drugs $0.00 $0.00 None
Browse Plan Formulary
CIGNA Medicare Rx Plan One (PDP)
$32.00 $320 No Gap Coverage S5617
-068
1 Preferred Generic Drugs $3.00 $7.50 None
Browse Plan Formulary
AARP MedicareRx Preferred (PDP)
$34.80 $0 No Gap Coverage S5820
-013
2 Non-Preferred Generic Drugs $8.00 $8.00 None
Browse Plan Formulary
Blue MedicareRx Standard (PDP)
$36.60 $320 No Gap Coverage S5596
-013
2 Non-Preferred Generic Drugs $7.00 $10.50 None
Browse Plan Formulary
Plan Name Monthly
Prem.
De- duct-
ible
Gap
Coverage
Plan
ID
Tier
Nbr.
Tier
Description
30-Day
Prfd.
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
First Health Part D Premier (PDP)
$38.20 $250 No Gap Coverage S5768
-017
1 Preferred Generic Drugs $5.00 $12.50 None
Browse Plan Formulary
Health Net Orange Option 1 (PDP)
$39.10 $320 No Gap Coverage S5678
-034
1 Preferred Generic Drugs $4.00 $8.00 None
Browse Plan Formulary
BravoRx (PDP)
$42.20 $320 No Gap Coverage S5998
-011
1 Tier 1 25% 25% None
Browse Plan Formulary
PrimeTime Prescription Drug Plan Basic (PDP)
$43.50 $320 No Gap Coverage S1480
-001
1 Generic Drugs $5.00 $15.00 None
Browse Plan Formulary
Medco Medicare Prescription Plan - Value (PDP)
$44.60 $320 No Gap Coverage S5660
-116
1 Preferred Generic Drugs $4.00 $8.00 None
Browse Plan Formulary
Humana Enhanced (PDP)
$46.10 $0 No Gap Coverage S5884
-072
1 Preferred Generic Drugs $7.00 $0.00 None
Browse Plan Formulary
Plan Name Monthly
Prem.
De- duct-
ible
Gap
Coverage
Plan
ID
Tier
Nbr.
Tier
Description
30-Day
Prfd.
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
United American - Preferred (PDP)
$49.80 $100 No Gap Coverage S5755
-017
1 Preferred Generic Drugs $3.00 $0.00 None
Browse Plan Formulary
WellCare Signature (PDP)
$57.00 $0 No Gap Coverage S5967
-048
1 Preferred Generic Drugs $0.00 $0.00 None
Browse Plan Formulary
CIGNA Medicare Rx Plan Two (PDP)
$62.40 $0 Few Generics S5617
-184
1 Preferred Generic Drugs $0.00 $0.00 None
Browse Plan Formulary
Medco Medicare Prescription Plan - Choice (PDP)
$63.40 $150 Many Generics S5660
-184
1 Preferred Generic Drugs $6.00 $0.00 None
Browse Plan Formulary
Rite Aid EnvisionRxPlus (PDP)
$66.30 $0 Some Generics S7694
-084
1 Preferred Generic Drugs $0.00 $6.00 None
Browse Plan Formulary
PrimeTime Prescription Drug Plan Enhanced (PDP)
$66.60 $0 All Generics S1480
-002
1 Generic Drugs $5.00 $15.00 None
Browse Plan Formulary
Plan Name Monthly
Prem.
De- duct-
ible
Gap
Coverage
Plan
ID
Tier
Nbr.
Tier
Description
30-Day
Prfd.
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
Blue MedicareRx Plus (PDP)
$66.70 $0 Some Generics S5596
-014
2 Non-Preferred Generic Drugs $7.00 $10.50 None
Browse Plan Formulary
Aetna Medicare Rx Premier (PDP)
$68.70 $0 Many Generics S5810
-184
1 Preferred Generic Drugs $4.00 $12.00 None
Browse Plan Formulary
Health Net Value Orange Option 2 (PDP)
$71.20 $0 No Gap Coverage S5678
-033
1 Preferred Generic Drugs $0.00 $0.00 None
Browse Plan Formulary
Community CCRx Choice (PDP)
$76.00 $0 No Gap Coverage S5803
-151
1 Generic Drugs $0.00 N/A None
Browse Plan Formulary
CVS Caremark Plus (PDP)
$78.50 $0 No Gap Coverage S5601
-029
1 Generic Drugs $0.00 $0.00 None
Browse Plan Formulary
AARP MedicareRx Enhanced (PDP)
$83.80 $0 Some Generics S5921
-053
2 Non-Preferred Generic Drugs $7.00 $7.00 None
Browse Plan Formulary
Plan Name Monthly
Prem.
De- duct-
ible
Gap
Coverage
Plan
ID
Tier
Nbr.
Tier
Description
30-Day
Prfd.
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
First Health Part D Premier Plus (PDP)
$92.10 $0 Some Generics and Some Brands S5670
-078
1 Preferred Generic Drugs $0.00 $0.00 None
Browse Plan Formulary
Blue MedicareRx Premier (PDP)
$107.60 $0 Many Generics and Some Brands S5596
-015
2 Non-Preferred Generic Drugs $7.00 $10.50 None
Browse Plan Formulary
Humana Complete (PDP)
$111.50 $0 Many Generics and Some Brands S5884
-042
1 Preferred Generic Drugs $5.00 $0.00 None
Browse Plan Formulary



What does all this mean? Here are a few notes to help you understand the above 2012 Medicare Part D Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region).

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the the standard $320 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.

    • No - This plan does not qualify for the $0 Premium for persons wit the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.

  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have four (4) tiers 1=Preferred Generics, 2=Preferred Brands, 3=Non-preferred Brands and Generics, 4=Specialty Drugs.
    • Drug Description - This is the Medicare Part D plan’s description of this particular drug tier.

  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on which tier the drug is in. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $2930) at a "Preferred" network pharmacy. In most cases, the "Preferred" network and network pharmacy pricing are the same. However, for example on the 2012 Humana Walmart-Preferred Rx Plan the cost-sharing is much higher at a network pharmacy over a "Preferred" network pharmacy. "Preferred" network pharmacies for this plan include only Walmart, Sam’s Club and RightSource.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).

  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.


(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2012 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.




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