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 -146 | Preferred Generic Drugs: $1.00 Non-Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 35%
| 3277
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First Health Part D Value Plus (PDP)

 |
$23.70 |
$0 |
No Gap Coverage |
No |
S5768 -151 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 27% Non-Preferred Brand Drugs: 42% Specialty Tier Drugs: 33%
| 3220
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 |
Health Net Orange Option 1 (PDP)

 |
$25.00 |
$320 |
No Gap Coverage |
Yes |
S5678 -001 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
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Community CCRx Basic (PDP)

 |
$25.10 |
$320 |
No Gap Coverage |
Yes |
S5803 -097 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 47% Specialty Tier Drugs: 25%
| 3019
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EnvisionRxPlus Silver (PDP)

 |
$25.20 |
$320 |
No Gap Coverage |
Yes |
S7694 -028 | 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 |
Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -062 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $24.00 Preferred brand name drugs: $35.00 Non-preferred brand name drugs: 41% Specialty drugs: 25%
| 3548
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| -- |
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BravoRx (PDP)

 |
$26.30 |
$320 |
No Gap Coverage |
Yes |
S5998 -032 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
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 |
 |
WellCare Classic (PDP)

 |
$26.40 |
$320 |
No Gap Coverage |
Yes |
S5967 -165 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 2724
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United American - Select (PDP)

 |
$26.50 |
$320 |
No Gap Coverage |
Yes |
S5755 -099 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3214
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MedicareRx Rewards Standard (PDP)

 |
$27.30 |
$320 |
No Gap Coverage |
Yes |
S5960 -134 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
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AARP MedicareRx Preferred (PDP)

 |
$28.80 |
$0 |
No Gap Coverage |
Yes |
S5820 -027 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 3874
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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 |
Blue MedicareRx (PDP)

 |
$30.20 |
$0 |
No Gap Coverage |
No |
S6506 -001 | Preferred Generic Drugs: $8.00 Non-Preferred Generic Drugs: $12.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: 46%
| 2956
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| new |
new |
new |
Humana Enhanced (PDP)

 |
$33.00 |
$0 |
No Gap Coverage |
No |
S5884 -086 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $71.00 Specialty Tier Drugs: 33%
| 4004
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First Health Part D Premier (PDP)

 |
$39.00 |
$250 |
No Gap Coverage |
No |
S5768 -121 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 38% Specialty Tier Drugs: 26%
| 3247
Browse Formulary |
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CVS Caremark Value (PDP)

 |
$40.50 |
$320 |
No Gap Coverage |
No |
S5601 -056 | Generic Drugs: $7.50 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
Browse Formulary |
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CIGNA Medicare Rx Plan One (PDP)

 |
$43.00 |
$320 |
No Gap Coverage |
No |
S5617 -138 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $81.00 Specialty Tier Drugs: 25%
| 3582
Browse Formulary |
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HealthSpring Prescription Drug Plan-Reg 28 (PDP)

 |
$46.60 |
$320 |
No Gap Coverage |
No |
S5932 -027 | Tier 1: 25% Tier 2: 25%
| 3167
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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 |
Medco Medicare Prescription Plan - Value (PDP)

 |
$47.20 |
$320 |
No Gap Coverage |
No |
S5660 -130 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 34% Specialty Tier Drugs: 25%
| 3440
Browse Formulary |
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United American - Preferred (PDP)

 |
$50.00 |
$110 |
No Gap Coverage |
No |
S5755 -031 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $9.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 30%
| 3499
Browse Formulary |
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WellCare Signature (PDP)

 |
$55.50 |
$0 |
No Gap Coverage |
No |
S5967 -062 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 2724
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Rite Aid EnvisionRxPlus (PDP)

 |
$61.20 |
$0 |
Some Generics |
No |
S7694 -098 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: 20% Preferred Brand Drugs: 15% Non-Preferred Brand Drugs: 30% Specialty Tier Drugs: 33%
| 2563
Browse Formulary |
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CIGNA Medicare Rx Plan Two (PDP)

 |
$69.80 |
$0 |
Few Generics |
No |
S5617 -198 | 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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Aetna Medicare Rx Premier (PDP)

 |
$70.00 |
$0 |
Many Generics |
No |
S5810 -198 | 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
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| -- |
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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)

 |
$71.80 |
$0 |
Some Generics |
No |
S5960 -158 | 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 |
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 |
 |
Medco Medicare Prescription Plan - Choice (PDP)

 |
$77.20 |
$150 |
Many Generics |
No |
S5660 -198 | Preferred Generic Drugs: $6.00 Non-Preferred Generic Drugs: $12.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 26%
| 3512
Browse Formulary |
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Community CCRx Choice (PDP)

 |
$81.00 |
$0 |
No Gap Coverage |
No |
S5803 -165 | 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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Health Net Orange Option 2 (PDP)

 |
$82.70 |
$0 |
No Gap Coverage |
No |
S5678 -007 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $75.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 5170
Browse Formulary |
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CVS Caremark Plus (PDP)

 |
$88.10 |
$0 |
No Gap Coverage |
No |
S5601 -057 | Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33%
| 3226
Browse Formulary |
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AARP MedicareRx Enhanced (PDP)

 |
$90.80 |
$0 |
Some Generics |
No |
S5921 -233 | 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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| 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 Plus (PDP)

 |
$96.70 |
$0 |
Some Generics and Some Brands |
No |
S5670 -144 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 44% Specialty Tier Drugs: 33%
| 3289
Browse Formulary |
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