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 -114 | Preferred Generic Drugs: $1.00 Non-Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 30%
| 3277
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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -066 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $24.00 Preferred brand name drugs: $39.00 Non-preferred brand name drugs: 38% Specialty drugs: 25%
| 3548
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| -- |
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CVS Caremark Value (PDP)

 |
$28.20 |
$320 |
No Gap Coverage |
Yes |
S5601 -064 | Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
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First Health Part D Value Plus (PDP)

 |
$28.90 |
$0 |
No Gap Coverage |
No |
S5768 -155 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 40% Specialty Tier Drugs: 33%
| 3220
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EnvisionRxPlus Silver (PDP)

 |
$29.60 |
$320 |
No Gap Coverage |
Yes |
S7694 -032 | 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 |
WellCare Classic (PDP)

 |
$31.50 |
$320 |
No Gap Coverage |
Yes |
S5967 -169 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 2724
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Health Net Orange Option 1 (PDP)

 |
$31.90 |
$320 |
No Gap Coverage |
Yes |
S5678 -002 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
Browse Formulary |
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Medco Medicare Prescription Plan - Value (PDP)

 |
$34.80 |
$320 |
No Gap Coverage |
No |
S5660 -134 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 35% Specialty Tier Drugs: 25%
| 3440
Browse Formulary |
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BravoRx (PDP)

 |
$37.10 |
$320 |
No Gap Coverage |
No |
S5998 -013 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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United American - Select (PDP)

 |
$37.60 |
$320 |
No Gap Coverage |
No |
S5755 -103 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $9.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3214
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First Health Part D Premier (PDP)

 |
$38.70 |
$250 |
No Gap Coverage |
No |
S5768 -082 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: 19% Non-Preferred Brand Drugs: 36% Specialty Tier Drugs: 26%
| 3247
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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 Cross MedicareRx Standard (PDP)

 |
$39.30 |
$320 |
No Gap Coverage |
No |
S5596 -033 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
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Blue Shield Medicare Basic Plan (PDP)

 |
$41.10 |
$320 |
No Gap Coverage |
No |
S2468 -003 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $75.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3135
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Humana Enhanced (PDP)

 |
$43.20 |
$0 |
No Gap Coverage |
No |
S5884 -030 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$48.20 |
$0 |
No Gap Coverage |
No |
S5820 -031 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $94.00 Specialty Tier Drugs: 33%
| 3874
Browse Formulary |
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Community CCRx Basic (PDP)

 |
$48.90 |
$320 |
No Gap Coverage |
No |
S5803 -101 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 46% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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HealthSpring Prescription Drug Plan-Reg 32 (PDP)

 |
$53.00 |
$320 |
No Gap Coverage |
No |
S5932 -031 | Tier 1: 25% Tier 2: 25%
| 3167
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 |
United American - Preferred (PDP)

 |
$54.80 |
$80 |
No Gap Coverage |
No |
S5755 -035 | 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: 31%
| 3499
Browse Formulary |
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WellCare Signature (PDP)

 |
$55.40 |
$0 |
No Gap Coverage |
No |
S5967 -066 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33%
| 2724
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Blue Shield Medicare Enhanced Plan (PDP)

 |
$55.60 |
$0 |
Many Generics |
No |
S2468 -004 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $75.00 Injectable Drug: 33% Specialty Tier Drugs: 33%
| 3135
Browse Formulary |
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CIGNA Medicare Rx Plan One (PDP)

 |
$56.20 |
$320 |
No Gap Coverage |
No |
S5617 -158 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $86.00 Specialty Tier Drugs: 25%
| 3582
Browse Formulary |
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Blue Cross MedicareRx Plus (PDP)

 |
$62.80 |
$0 |
Some Generics |
No |
S5596 -034 | Preferred Generic Drugs: $2.00 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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Rite Aid EnvisionRxPlus (PDP)

 |
$78.60 |
$0 |
Some Generics |
No |
S7694 -102 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: 20% Preferred Brand Drugs: 15% Non-Preferred Brand Drugs: 30% Specialty Tier Drugs: 33%
| 2563
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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 |
CVS Caremark Plus (PDP)

 |
$81.90 |
$0 |
No Gap Coverage |
No |
S5601 -065 | 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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 |
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Medco Medicare Prescription Plan - Choice (PDP)

 |
$82.50 |
$150 |
Many Generics |
No |
S5660 -202 | 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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Health Net Orange Option 2 (PDP)

 |
$87.60 |
$0 |
No Gap Coverage |
No |
S5678 -008 | 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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Community CCRx Choice (PDP)

 |
$91.50 |
$0 |
No Gap Coverage |
No |
S5803 -169 | 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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Aetna Medicare Rx Premier (PDP)

 |
$92.20 |
$0 |
Many Generics |
No |
S5810 -202 | 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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AARP MedicareRx Enhanced (PDP)

 |
$96.10 |
$0 |
Some Generics |
No |
S5921 -003 | 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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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
Blue Cross MedicareRx Gold (PDP)

 |
$107.30 |
$0 |
Many Generics and Some Brands |
No |
S5596 -035 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 33% Specialty Tier Drugs: 33%
| 4669
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First Health Part D Premier Plus (PDP)

 |
$107.30 |
$0 |
Some Generics and Some Brands |
No |
S5674 -059 | 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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Blue Shield Medicare Premium Plan (PDP)

 |
$108.20 |
$0 |
Many Generics and Some Brands |
No |
S2468 -002 | Generic Drugs: $7.00 Preferred Generic Drugs: $45.00 Non-Preferred Brand Drugs: $75.00 Injectable Drug: 33% Specialty Tier Drugs: 33%
| 3674
Browse Formulary |
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Humana Complete (PDP)

 |
$114.90 |
$0 |
Many Generics and Some Brands |
No |
S5884 -060 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $69.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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