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 -111 | 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)

 |
$26.40 |
$0 |
No Gap Coverage |
No |
S5768 -150 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 33%
| 3220
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EnvisionRxPlus Silver (PDP)

 |
$29.90 |
$320 |
No Gap Coverage |
Yes |
S7694 -027 | 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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Community CCRx Basic (PDP)

 |
$30.20 |
$320 |
No Gap Coverage |
Yes |
S5803 -096 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 49% Specialty Tier Drugs: 25%
| 3019
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First Health Part D Premier (PDP)

 |
$33.10 |
$250 |
No Gap Coverage |
Yes |
S5768 -119 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 37% 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 |
WellCare Classic (PDP)

 |
$34.00 |
$320 |
No Gap Coverage |
Yes |
S5967 -164 | 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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HealthSpring Prescription Drug Plan-Reg 27 (PDP)

 |
$39.00 |
$320 |
No Gap Coverage |
No |
S5932 -026 | Tier 1: 25% Tier 2: 25%
| 3167
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Blue MedicareRx Standard (PDP)

 |
$39.20 |
$320 |
No Gap Coverage |
No |
S5596 -059 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 3212
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United American - Select (PDP)

 |
$40.80 |
$320 |
No Gap Coverage |
No |
S5755 -098 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3214
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Health Net Orange Option 1 (PDP)

 |
$41.60 |
$320 |
No Gap Coverage |
No |
S5678 -060 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
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Humana Enhanced (PDP)

 |
$43.30 |
$0 |
No Gap Coverage |
No |
S5884 -085 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $71.00 Specialty Tier Drugs: 33%
| 4004
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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 |
AARP MedicareRx Preferred (PDP)

 |
$47.20 |
$0 |
No Gap Coverage |
No |
S5820 -026 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 3874
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Medco Medicare Prescription Plan - Value (PDP)

 |
$47.50 |
$320 |
No Gap Coverage |
No |
S5660 -129 | 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
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CVS Caremark Value (PDP)

 |
$50.60 |
$320 |
No Gap Coverage |
No |
S5601 -054 | Generic Drugs: $7.25 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
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United American - Preferred (PDP)

 |
$55.10 |
$130 |
No Gap Coverage |
No |
S5755 -030 | 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: 29%
| 3499
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Aetna Medicare Rx Essentials (PDP)

 |
$55.60 |
$320 |
No Gap Coverage |
No |
S5810 -061 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 25%
| 3548
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| -- |
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CIGNA Medicare Rx Plan One (PDP)

 |
$55.90 |
$320 |
No Gap Coverage |
No |
S5617 -133 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 25%
| 3582
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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 Signature (PDP)

 |
$65.10 |
$0 |
No Gap Coverage |
No |
S5967 -061 | 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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Health Net Value Orange Option 2 (PDP)

 |
$70.60 |
$0 |
No Gap Coverage |
No |
S5678 -059 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $32.00 Non-Preferred Brand Drugs: $64.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 4297
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Blue MedicareRx Plus (PDP)

 |
$73.40 |
$0 |
Some Generics |
No |
S5596 -060 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 3443
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Rite Aid EnvisionRxPlus (PDP)

 |
$74.30 |
$0 |
Some Generics |
No |
S7694 -097 | 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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Medco Medicare Prescription Plan - Choice (PDP)

 |
$79.70 |
$150 |
Many Generics |
No |
S5660 -197 | 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
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CVS Caremark Plus (PDP)

 |
$79.90 |
$0 |
No Gap Coverage |
No |
S5601 -055 | Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33%
| 3226
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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 |
Community CCRx Choice (PDP)

 |
$90.50 |
$0 |
No Gap Coverage |
No |
S5803 -164 | Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 3019
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Aetna Medicare Rx Premier (PDP)

 |
$94.50 |
$0 |
Many Generics |
No |
S5810 -197 | 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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AARP MedicareRx Enhanced (PDP)

 |
$98.80 |
$0 |
Some Generics |
No |
S5921 -223 | 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
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First Health Part D Premier Plus (PDP)

 |
$105.40 |
$0 |
Some Generics and Some Brands |
No |
S5670 -138 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 41% Specialty Tier Drugs: 33%
| 3289
Browse Formulary |
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Blue MedicareRx Premier (PDP)

 |
$127.40 |
$0 |
Many Generics and Some Brands |
No |
S5596 -061 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 4669
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