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 -108 | 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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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -055 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $13.00 Preferred brand name drugs: $33.00 Non-preferred brand name drugs: 41% Specialty drugs: 25%
| 3548
Browse Formulary |
| -- |
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First Health Part D Value Plus (PDP)

 |
$28.10 |
$0 |
No Gap Coverage |
No |
S5768 -144 | 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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CVS Caremark Value (PDP)

 |
$29.70 |
$320 |
No Gap Coverage |
Yes |
S5601 -042 | Generic Drugs: $5.25 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
Browse Formulary |
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EnvisionRxPlus Silver (PDP)

 |
$31.40 |
$320 |
No Gap Coverage |
Yes |
S7694 -021 | 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 |
CIGNA Medicare Rx Plan One (PDP)

 |
$32.00 |
$320 |
No Gap Coverage |
Yes |
S5617 -103 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25%
| 3582
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Community CCRx Basic (PDP)

 |
$32.20 |
$320 |
No Gap Coverage |
Yes |
S5803 -090 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 45% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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Windsor Rx (PDP)

 |
$32.40 |
$320 |
No Gap Coverage |
Yes |
S4802 -012 | Generic Drugs: $6.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25%
| 2753
Browse Formulary |
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HealthSpring Prescription Drug Plan-Reg 21 (PDP)

 |
$33.50 |
$320 |
No Gap Coverage |
Yes |
S5932 -020 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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Health Net Orange Option 1 (PDP)

 |
$34.60 |
$320 |
No Gap Coverage |
Yes |
S5678 -048 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $83.00 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 |
Yes |
S5660 -123 | 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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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
United American - Select (PDP)

 |
$35.20 |
$320 |
No Gap Coverage |
No |
S5755 -092 | 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
Browse Formulary |
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MedicareRx Rewards Standard (PDP)

 |
$36.40 |
$320 |
No Gap Coverage |
Yes |
S5960 -127 | 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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WellCare Classic (PDP)

 |
$36.90 |
$320 |
No Gap Coverage |
Yes |
S5967 -158 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $91.00 Specialty Tier Drugs: 25%
| 2724
Browse Formulary |
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RxBLUE BASIC (PDP)

 |
$38.70 |
$320 |
No Gap Coverage |
No |
S5937 -001 | Generic Drugs: $3.00 Brand Drugs: $46.00 Specialty Tier Drugs: 25%
| 3118
Browse Formulary |
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Humana Enhanced (PDP)

 |
$43.70 |
$0 |
No Gap Coverage |
No |
S5884 -019 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $78.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$44.20 |
$0 |
No Gap Coverage |
No |
S5820 -020 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $94.00 Specialty Tier Drugs: 33%
| 3874
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 |
BravoRx (PDP)

 |
$45.10 |
$320 |
No Gap Coverage |
No |
S5998 -026 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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First Health Part D Premier (PDP)

 |
$48.30 |
$250 |
No Gap Coverage |
No |
S5768 -044 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 21% Non-Preferred Brand Drugs: 37% Specialty Tier Drugs: 26%
| 3247
Browse Formulary |
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United American - Preferred (PDP)

 |
$51.40 |
$80 |
No Gap Coverage |
No |
S5755 -024 | 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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Health Net Value Orange Option 2 (PDP)

 |
$64.90 |
$0 |
No Gap Coverage |
No |
S5678 -047 | 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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WellCare Signature (PDP)

 |
$65.40 |
$0 |
No Gap Coverage |
No |
S5967 -055 | 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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Rite Aid EnvisionRxPlus (PDP)

 |
$67.50 |
$0 |
Some Generics |
No |
S7694 -091 | 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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| 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)

 |
$70.00 |
$0 |
Some Generics |
No |
S5960 -153 | 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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 |
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Community CCRx Choice (PDP)

 |
$79.40 |
$0 |
No Gap Coverage |
No |
S5803 -158 | 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)

 |
$90.40 |
$0 |
Some Generics |
No |
S5921 -333 | 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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Aetna Medicare Rx Premier (PDP)

 |
$91.30 |
$0 |
Many Generics |
No |
S5810 -191 | 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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RxBLUE PLUS (PDP)

 |
$98.20 |
$0 |
Many Generics |
No |
S5937 -002 | Generic Drugs: $3.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 5063
Browse Formulary |
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First Health Part D Premier Plus (PDP)

 |
$102.10 |
$0 |
Some Generics and Some Brands |
No |
S5670 -114 | 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)

 |
$107.70 |
$0 |
Many Generics and Some Brands |
No |
S5884 -049 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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 |
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