2013 / 2014 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 | Total Formulary Drugs | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2013 Blue Rx Plus (PDP) | $61.40 | $250 | No additional gap coverage, only the Donut Hole Discount | No | S5593 -002 | $4.00 | $12.00 | 25% | 48% | 4362 2013 Formulary | ||
2014 Blue Rx Plus (PDP) | $74.30 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $11.00 | 25% | 50% | 4342 2014 Formulary | |||
2013 Blue Rx Complete (PDP) | $113.20 | $0 | Many Generics | No | S5593 -003 | $7.00 | $40.00 | $70.00 | 33% | 5246 2013 Formulary | ||
2014 Blue Rx Complete (PDP) | $130.80 | $0 | Many Generics | No | $7.00 | $40.00 | $70.00 | 33% | 5227 2014 Formulary | |||
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