2012 / 2013 Medicare Part D Plan Information Click here to jump to the Chart Legend | ||||||||||||
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Plan Name | Monthly Premium |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
$0 Prem. with Full LIS? |
Plan ID |
Cost-Sharing | Members In This Plan | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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-- This plan not offered in 2012 -- | S5967 -187 | |||||||||||
2013 WellCare Extra (PDP) | $44.00 | $0 | Many Generics | No | $0.00 | 25% | 25% | 50% | tbd members | |||
2012 Rite Aid EnvisionRxPlus (PDP) | $68.10 | $0 | Some Generics | No | S7694 -085 | $0.00 | 20% | 15% | 30% | 206 members | ||
2013 EnvisionRxPlus Gold (PDP) | $54.50 | $150 | Some Generics | No | $2.00 | $5.00 | $25.00 | 30% | tbd members | |||
2012 Blue MedicareRx Plus (PDP) | $70.90 | $0 | Some Generics | No | S5596 -018 | $2.00 | $7.00 | $45.00 | $90.00 | 23,450 members | ||
2013 Blue MedicareRx Plus (PDP) | $75.80 | $0 | Few Generics | No | $2.00 | $7.00 | $45.00 | $90.00 | tbd members | |||
2012 CIGNA Medicare Rx Plan Two (PDP) | $67.40 | $0 | Few Generics | No | S5617 -185 | $0.00 | $5.00 | $41.00 | $85.00 | 2,768 members | ||
2013 Cigna Medicare Rx Plan Two (PDP) | $76.90 | $0 | Few Generics | No | $0.00 | $10.00 | $45.00 | $90.00 | tbd members | |||
-- This plan not offered in 2012 -- | S0064 -050 | |||||||||||
2013 SmartD Rx Plus (PDP) | $77.60 | $0 | Some Generics | No | $0.00 | $20.00 | $32.00 | $85.00 | tbd members | |||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Plan Members | |||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | ||||||
2012 Medco Medicare Prescription Plan - Choice (PDP) | $70.90 | $150 | Many Generics | No | S5660 -185 | $6.00 | $12.00 | $45.00 | $95.00 | 6,536 members | ||
2013 Express Scripts Medicare - Choice (PDP) | $78.80 | $200 | Many Generics | No | $8.00 | $45.00 | $95.00 | 28% | tbd members | |||
2012 AARP MedicareRx Enhanced (PDP) | $91.80 | $0 | Some Generics | No | S5921 -063 | $4.00 | $7.00 | $40.00 | $76.00 | 4,824 members | ||
2013 AARP MedicareRx Enhanced (PDP) | $88.20 | $0 | Some Generics, Some Brands |
No | $2.00 | $5.00 | $40.00 | $76.00 | tbd members | |||
2012 First Health Part D Premier Plus (PDP) | $101.90 | $0 | Some Generics, Some Brands |
No | S5674 -029 | $0.00 | $20.00 | 25% | 41% | 5,855 members | ||
2013 First Health Part D Premier Plus (PDP) | $100.10 | $0 | Some Generics, Some Brands |
No | $0.00 | $20.00 | 25% | 41% | tbd members | |||
2012 CVS Caremark Plus (PDP) | $85.50 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -031 | $0.00 | $40.00 | $90.00 | 33% | 3,233 members | ||
2013 SilverScript Plus (PDP) | $101.60 | $0 | Many Generics, Some Brands |
No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 Aetna Medicare Rx Premier (PDP) | $84.90 | $0 | Many Generics | No | S5810 -185 | $4.00 | $25.00 | $35.00 | $80.00 | 4,859 members | ||
2013 Aetna Medicare Rx Premier (PDP) | $106.00 | $0 | Many Generics, Some Brands |
No | $5.00 | $33.00 | $45.00 | tbd | tbd members | |||
2012 Blue MedicareRx Premier (PDP) | $117.10 | $0 | Many Generics, Some Brands |
No | S5596 -019 | $2.00 | $7.00 | $45.00 | $90.00 | 14,569 members | ||
2013 Blue MedicareRx Premier (PDP) | $110.70 | $0 | Many Generics, Some Brands |
No | $2.00 | $7.00 | $45.00 | $90.00 | tbd members | |||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Plan Members | |||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | ||||||
2012 Humana Complete (PDP) | $110.10 | $0 | Many Generics, Some Brands |
No | S5884 -043 | $4.00 | $37.00 | $70.00 | 33% | 4,105 members | ||
2013 Humana Complete (PDP) | $113.80 | $0 | Some Generics, Some Brands |
No | $4.00 | $37.00 | $70.00 | 33% | tbd members | |||
2012 BravoRx (PDP) | $36.70 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5998 -021 | 25% | 25% | 25% | 6,146 members | |||
-- Members will be assigned to HealthSpring Prescription Drug Plan S5932-014 -- | ||||||||||||
2012 Community CCRx Basic (PDP) | $33.60 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5803 -084 | $2.00 | 25% | 46% | 25% | 86,521 members | ||
-- Members will be assigned to SilverScript Basic S5601-030 -- | ||||||||||||
2012 Health Net Orange Option 1 (PDP) | $37.40 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5678 -036 | $4.00 | $45.00 | $85.00 | 25% | 3,906 members | ||
-- Members will be assigned to SilverScript Basic S5601-030 -- | ||||||||||||
2012 Community CCRx Choice (PDP) | $79.00 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5803 -152 | $0.00 | $40.00 | $70.00 | 33% | 6,625 members | ||
-- Members will be assigned to SilverScript Plus S5601-031 -- | ||||||||||||
2012 Health Net Value Orange Option 2 (PDP) | $80.30 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -035 | $0.00 | $32.00 | $64.00 | 33% | 1,042 members | ||
-- Members will be assigned to SilverScript Plus S5601-031 -- | ||||||||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Plan Members | |||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | ||||||
2012 WellCare Signature (PDP) | $68.60 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5967 -049 | $0.00 | $20.00 | $45.00 | $90.00 | 10,127 members | ||
-- Members will be assigned to WellCare Classic S5967-152 -- | ||||||||||||
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