2012 Medicare Part D Plan Information
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| Plan Name |
Monthly Prem. |
Deduct- ible |
(Donut Hole) Gap Coverage |
$0 Prem. with Full LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
Total Formulary Drugs |
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Humana Walmart-Preferred Rx Plan (PDP)

 |
$15.10 |
$320 |
No Gap Coverage |
Yes |
S5884 -141 | Preferred Generic Drugs: $1.00 Non-Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 35%
| 3277
Browse Formulary |
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Windsor Rx (PDP)

 |
$20.80 |
$320 |
No Gap Coverage |
Yes |
S2505 -003 | Generic Drugs: $6.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 25%
| 2753
Browse Formulary |
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First Health Part D Value Plus (PDP)

 |
$21.70 |
$0 |
No Gap Coverage |
No |
S5768 -142 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 40% Specialty Tier Drugs: 33%
| 3220
Browse Formulary |
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Health Net Orange Option 1 (PDP)

 |
$25.30 |
$320 |
No Gap Coverage |
Yes |
S5678 -044 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $84.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
Browse Formulary |
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EnvisionRxPlus Silver (PDP)

 |
$28.30 |
$320 |
No Gap Coverage |
Yes |
S7694 -019 | Preferred Generic Drugs: 25% Non-Preferred Generic Drugs: 25% Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 25% Specialty Tier Drugs: 25%
| 2618
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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
BravoRx (PDP)

 |
$29.20 |
$320 |
No Gap Coverage |
Yes |
S5998 -024 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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 |
 |
Community CCRx Basic (PDP)

 |
$29.80 |
$320 |
No Gap Coverage |
Yes |
S5803 -088 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 47% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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 |
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CIGNA Medicare Rx Plan One (PDP)

 |
$30.20 |
$320 |
No Gap Coverage |
Yes |
S5617 -225 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $78.00 Specialty Tier Drugs: 25%
| 3582
Browse Formulary |
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Medco Medicare Prescription Plan - Value (PDP)

 |
$30.70 |
$320 |
No Gap Coverage |
Yes |
S5660 -121 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 40% Specialty Tier Drugs: 25%
| 3440
Browse Formulary |
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CVS Caremark Value (PDP)

 |
$30.80 |
$320 |
No Gap Coverage |
Yes |
S5601 -038 | Generic Drugs: $5.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
Browse Formulary |
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United American - Preferred (PDP)

 |
$30.90 |
$145 |
No Gap Coverage |
Yes |
S5755 -022 | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $12.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 29%
| 3499
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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
First Health Part D Premier (PDP)

 |
$31.50 |
$250 |
No Gap Coverage |
Yes |
S5768 -043 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 38% Specialty Tier Drugs: 26%
| 3247
Browse Formulary |
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HealthSpring Prescription Drug Plan-Reg 19 (PDP)

 |
$32.00 |
$320 |
No Gap Coverage |
Yes |
S5932 -018 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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MedicareRx Rewards Standard (PDP)

 |
$32.20 |
$320 |
No Gap Coverage |
Yes |
S5960 -125 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $29.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
Browse Formulary |
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Aetna Medicare Rx Essentials (PDP)

 |
$33.10 |
$320 |
No Gap Coverage |
Yes |
S5810 -053 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: 40% Specialty Tier Drugs: 25%
| 3548
Browse Formulary |
| -- |
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WellCare Classic (PDP)

 |
$33.10 |
$320 |
No Gap Coverage |
Yes |
S5967 -156 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 2724
Browse Formulary |
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AR Blue Cross - Medi-Pak Rx Basic (PDP)

 |
$34.40 |
$255 |
No Gap Coverage |
No |
S5795 -003 | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 25%
| 3021
Browse Formulary |
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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
Humana Enhanced (PDP)

 |
$37.90 |
$0 |
No Gap Coverage |
No |
S5884 -077 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $69.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$42.80 |
$0 |
No Gap Coverage |
No |
S5820 -018 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 3874
Browse Formulary |
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EnvisionRxPlus Gold (PDP)

 |
$59.60 |
$0 |
Some Generics |
No |
S7694 -089 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: 15% Preferred Brand Drugs: 15% Non-Preferred Brand Drugs: 30% Specialty Tier Drugs: 33%
| 2563
Browse Formulary |
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Health Net Value Orange Option 2 (PDP)

 |
$60.80 |
$0 |
No Gap Coverage |
No |
S5678 -043 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $32.00 Non-Preferred Brand Drugs: $64.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 4297
Browse Formulary |
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 |
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CIGNA Medicare Rx Plan Two (PDP)

 |
$63.20 |
$0 |
Few Generics |
No |
S5617 -189 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 33%
| 3754
Browse Formulary |
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WellCare Signature (PDP)

 |
$63.80 |
$0 |
No Gap Coverage |
No |
S5967 -053 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 33%
| 2724
Browse Formulary |
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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
MedicareRx Rewards Plus (PDP)

 |
$67.60 |
$0 |
Some Generics |
No |
S5960 -151 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 33% Specialty Tier Drugs: 33%
| 3443
Browse Formulary |
 |
 |
 |
Aetna Medicare Rx Premier (PDP)

 |
$73.10 |
$0 |
Many Generics |
No |
S5810 -189 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $25.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33%
| 3548
Browse Formulary |
| -- |
 |
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Community CCRx Choice (PDP)

 |
$78.40 |
$0 |
No Gap Coverage |
No |
S5803 -156 | Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 3019
Browse Formulary |
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 |
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AARP MedicareRx Enhanced (PDP)

 |
$85.10 |
$0 |
Some Generics |
No |
S5921 -313 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $76.00 Specialty Tier Drugs: 33%
| 5030
Browse Formulary |
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 |
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AR Blue Cross - Medi-Pak Rx Premier (PDP)

 |
$90.80 |
$0 |
Many Generics |
No |
S5795 -002 | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 25%
| 5012
Browse Formulary |
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 |
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First Health Part D Premier Plus (PDP)

 |
$103.00 |
$0 |
Some Generics and Some Brands |
No |
S5670 -102 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 43% Specialty Tier Drugs: 33%
| 3289
Browse Formulary |
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 |
 |
| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
Humana Complete (PDP)

 |
$110.20 |
$0 |
Many Generics and Some Brands |
No |
S5884 -047 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $72.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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 |
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