2012 / 2013 Medicare Part D Plan Information Click here to jump to the Chart Legend | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
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 |
||||||
-- This plan not offered in 2012 -- | S5601 -130 | |||||||||||
2013 SilverScript Choice (PDP) | $29.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 CVS Caremark Value (PDP) | $29.70 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5601 -042 | $5.25 | $45.00 | $95.00 | 25% | 39,506 members | ||
2013 SilverScript Basic (PDP) | $33.60 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | $2.00 | 23% | 45% | 33% | tbd members | |||
-- This plan not offered in 2012 -- | S5601 -108 | |||||||||||
2013 SilverScript Plus (PDP) | $99.20 | $0 | Many Generics, Some Brands |
No | $0.00 | $34.00 | 35% | 33% | tbd members | |||
2012 Health Net Orange Option 1 (PDP) | $34.60 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5678 -048 | $4.00 | $38.00 | $83.00 | 25% | 1,976 members | ||
-- Members will be assigned to SilverScript Basic S5601-042 -- | ||||||||||||
2012 Community CCRx Basic (PDP) | $32.20 | $320 | No additional gap coverage, only the Donut Hole Discount | Yes | S5803 -090 | $2.00 | 25% | 45% | 25% | 45,533 members | ||
-- Members will be assigned to SilverScript Basic S5601-042 -- | ||||||||||||
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 Health Net Value Orange Option 2 (PDP) | $64.90 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5678 -047 | $0.00 | $32.00 | $64.00 | 33% | 1,638 members | ||
-- Members will be assigned to SilverScript Plus S5601-108 -- | ||||||||||||
2012 Community CCRx Choice (PDP) | $79.40 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5803 -158 | $0.00 | $40.00 | $70.00 | 33% | 3,935 members | ||
-- Members will be assigned to SilverScript Plus S5601-108 -- | ||||||||||||
|