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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) (S4802-157) Benefits & Contact Info |
$0.50 | $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 | |||
---|---|---|---|---|---|---|---|---|
Blue MedicareRx Plus (PDP) (S5726-014) Benefits & Contact Info |
$70.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 33% | 3,199 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 | |||
---|---|---|---|---|---|---|---|---|
Wellcare Value Script (PDP) (S4802-157) Benefits & Contact Info |
$0.50 | $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 | 61,302 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript SmartSaver (PDP) (S5601-199) Benefits & Contact Info |
$3.30 | $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% | 46,269 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
SilverScript Choice (PDP) (S5601-048) Benefits & Contact Info |
$43.50 | $545 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $7.00 Preferred Brand: 16% Non-Preferred Drug: 36% Specialty Tier: 25% | 25,459 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Humana Walmart Value Rx Plan (PDP) (S5884-203) Benefits & Contact Info |
$39.00 | $545 | Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 17% Non-Preferred Drug: 50% Specialty Tier: 25% | 22,912 Browse Formulary | |||
Higher cost-sharing at non-preferred pharmacies. Click for details: | ||||||||
Blue MedicareRx Plus (PDP) (S5726-014) Benefits & Contact Info |
$70.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $1.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 33% | 17,530 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) (S4802-157) Benefits & Contact Info |
$0.50 | $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) (S5601-199) Benefits & Contact Info |
$3.30 | $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) (S5617-374) Benefits & Contact Info |
$18.00 | $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) (S7126-126) Benefits & Contact Info |
$22.00 | $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. |