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 -136 | 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)

 |
$24.20 |
$0 |
No Gap Coverage |
No |
S5768 -136 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 33%
| 3220
Browse Formulary |
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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -047 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $10.00 Preferred brand name drugs: $33.00 Non-preferred brand name drugs: 37% Specialty drugs: 25%
| 3548
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| -- |
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CIGNA Medicare Rx Plan One (PDP)

 |
$30.50 |
$320 |
No Gap Coverage |
Yes |
S5617 -221 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 25%
| 3582
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Community CCRx Basic (PDP)

 |
$33.00 |
$320 |
No Gap Coverage |
Yes |
S5803 -082 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 46% Specialty Tier Drugs: 25%
| 3019
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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)

 |
$33.10 |
$250 |
No Gap Coverage |
Yes |
S5768 -016 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 37% Specialty Tier Drugs: 26%
| 3247
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EnvisionRxPlus Silver (PDP)

 |
$33.30 |
$320 |
No Gap Coverage |
Yes |
S7694 -070 | Preferred Generic Drugs: 25% Non-Preferred Generic Drugs: 25% Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 25% Specialty Tier Drugs: 25%
| 2618
Browse Formulary |
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CVS Caremark Value (PDP)

 |
$33.70 |
$320 |
No Gap Coverage |
Yes |
S5601 -026 | Generic Drugs: $7.25 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
Browse Formulary |
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United American - Select (PDP)

 |
$34.00 |
$320 |
No Gap Coverage |
Yes |
S5755 -084 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3214
Browse Formulary |
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HealthSpring Prescription Drug Plan-Reg 13 (PDP)

 |
$34.50 |
$320 |
No Gap Coverage |
Yes |
S5932 -012 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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Medco Medicare Prescription Plan - Value (PDP)

 |
$35.00 |
$320 |
No Gap Coverage |
Yes |
S5660 -115 | 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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| 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)

 |
$35.60 |
$320 |
No Gap Coverage |
Yes |
S5967 -150 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 2724
Browse Formulary |
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BravoRx (PDP)

 |
$36.00 |
$320 |
No Gap Coverage |
Yes |
S5998 -009 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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Health Net Orange Option 1 (PDP)

 |
$36.60 |
$320 |
No Gap Coverage |
No |
S5678 -032 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $87.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$37.60 |
$0 |
No Gap Coverage |
No |
S5820 -012 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $9.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 3874
Browse Formulary |
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Humana Enhanced (PDP)

 |
$37.60 |
$0 |
No Gap Coverage |
No |
S5884 -071 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $73.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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United American - Preferred (PDP)

 |
$41.80 |
$130 |
No Gap Coverage |
No |
S5755 -016 | 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
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 Standard (PDP)

 |
$49.40 |
$320 |
No Gap Coverage |
No |
S5960 -119 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
Browse Formulary |
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PriorityMedicare Rx (PDP)

 |
$52.10 |
$205 |
No Gap Coverage |
No |
S5857 -001 | Generic Drugs: $9.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 27%
| 3428
Browse Formulary |
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WellCare Signature (PDP)

 |
$58.50 |
$0 |
No Gap Coverage |
No |
S5967 -047 | 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
Browse Formulary |
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Alliance Medicare RX (PDP)

 |
$59.20 |
$175 |
No Gap Coverage |
No |
S3440 -001 | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: 28% Specialty Tier Drugs: 28%
| 3351
Browse Formulary |
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Prescription Blue Option A (PDP)

 |
$59.60 |
$270 |
No Gap Coverage |
No |
S5584 -001 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4024
Browse Formulary |
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Medco Medicare Prescription Plan - Choice (PDP)

 |
$59.90 |
$150 |
Many Generics |
No |
S5660 -183 | 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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| 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 Two (PDP)

 |
$61.00 |
$0 |
Few Generics |
No |
S5617 -183 | 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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 |
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Health Net Value Orange Option 2 (PDP)

 |
$61.90 |
$0 |
No Gap Coverage |
No |
S5678 -031 | 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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Aetna Medicare Rx Premier (PDP)

 |
$68.50 |
$0 |
Many Generics |
No |
S5810 -183 | 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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Rite Aid EnvisionRxPlus (PDP)

 |
$72.50 |
$0 |
Some Generics |
No |
S7694 -071 | 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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CVS Caremark Plus (PDP)

 |
$78.60 |
$0 |
No Gap Coverage |
No |
S5601 -027 | 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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Community CCRx Choice (PDP)

 |
$82.80 |
$0 |
No Gap Coverage |
No |
S5803 -150 | 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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 |
 |
| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
AARP MedicareRx Enhanced (PDP)

 |
$84.00 |
$0 |
Some Generics |
No |
S5921 -163 | 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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Prescription Blue Option B (PDP)

 |
$85.90 |
$0 |
Many Generics |
No |
S5584 -002 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 25% Specialty Tier Drugs: 30%
| 4148
Browse Formulary |
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MedicareRx Rewards Plus (PDP)

 |
$91.40 |
$0 |
Some Generics |
No |
S5960 -149 | 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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First Health Part D Premier Plus (PDP)

 |
$94.80 |
$0 |
Some Generics and Some Brands |
No |
S5670 -072 | 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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Humana Complete (PDP)

 |
$111.90 |
$0 |
Many Generics and Some Brands |
No |
S5884 -041 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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