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Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance 30-Day Supply | Total Formulary Drugs | |||
---|---|---|---|---|---|---|---|---|
Wellcare Value Script (PDP) (S4802-153) Benefits & Contact Info |
$1.60 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $11.00 | 3,387 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
Wellcare Medicare Rx Value Plus (PDP) (S4802-222) Benefits & Contact Info |
$78.90 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $11.00 | 3,384 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance |
State Members | |||
---|---|---|---|---|---|---|---|---|
SilverScript Choice (PDP) (S5601-038) Benefits & Contact Info |
$37.50 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: 16% Non-Preferred Drug: 40% Specialty Tier: 25% | 43,113 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Wellcare Value Script (PDP) (S4802-153) Benefits & Contact Info |
$1.60 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $11.00 | 35,117 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Wellcare Classic (PDP) (S4802-073) Benefits & Contact Info |
$33.80 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 20% Non-Preferred Drug: 41% Specialty Tier: 25% Select Care Drugs: $0.00 | 22,270 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-198) Benefits & Contact Info |
$33.00 | $545 | Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 17% Non-Preferred Drug: 40% Specialty Tier: 25% | 21,395 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript SmartSaver (PDP) (S5601-194) Benefits & Contact Info |
$9.90 | $280 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 24% Non-Preferred Drug: 50% Specialty Tier: 29% | 19,486 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: |
Plan Name Plan ID |
Monthly Prem. |
Dedu- ctible |
Additional Gap Coverage |
Preferred Pharmacy Copay/Coinsurance | Total Drugs | |||
---|---|---|---|---|---|---|---|---|
Wellcare Value Script (PDP) (S4802-153) Benefits & Contact Info |
$1.60 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 25% Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $11.00 | 3,387 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript SmartSaver (PDP) (S5601-194) Benefits & Contact Info |
$9.90 | $280 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: 24% Non-Preferred Drug: 50% Specialty Tier: 29% | 3,634 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Cigna Saver Rx (PDP) (S5617-369) Benefits & Contact Info |
$19.20 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $6.00 Preferred Brand: 18% Non-Preferred Drug: 50% Specialty Tier: 25% | 3,268 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Mutual of Omaha Rx Essential (PDP) (S7126-121) Benefits & Contact Info |
$22.80 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: 20% Non-Preferred Drug: 48% Specialty Tier: 25% | 3,165 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: |
A few notes to help with the understanding of the 2024 Medicare Part D Plan chart above.
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, we cannot guarantee the accuracy of this information. Through the application process we will provide you with the most up-to-the-minute information/pricing. |