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 -133 | 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)

 |
$24.70 |
$0 |
No Gap Coverage |
No |
S5768 -131 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 40% Specialty Tier Drugs: 33%
| 3220
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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -042 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $10.00 Preferred brand name drugs: $31.00 Non-preferred brand name drugs: 42% Specialty drugs: 25%
| 3548
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| -- |
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CIGNA Medicare Rx Plan One (PDP)

 |
$30.20 |
$320 |
No Gap Coverage |
Yes |
S5617 -217 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 25%
| 3582
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First Health Part D Premier (PDP)

 |
$30.60 |
$250 |
No Gap Coverage |
Yes |
S5768 -039 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: 19% Non-Preferred Brand Drugs: 35% 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 |
Community CCRx Basic (PDP)

 |
$32.10 |
$320 |
No Gap Coverage |
Yes |
S5803 -077 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 47% Specialty Tier Drugs: 25%
| 3019
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United American - Select (PDP)

 |
$32.40 |
$320 |
No Gap Coverage |
Yes |
S5755 -079 | 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
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EnvisionRxPlus Silver (PDP)

 |
$32.60 |
$320 |
No Gap Coverage |
Yes |
S7694 -008 | 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)

 |
$32.70 |
$320 |
No Gap Coverage |
Yes |
S5601 -016 | 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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Medco Medicare Prescription Plan - Value (PDP)

 |
$33.00 |
$320 |
No Gap Coverage |
Yes |
S5660 -110 | 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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WellCare Classic (PDP)

 |
$35.40 |
$0 |
No Gap Coverage |
No |
S5967 -145 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 2724
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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 |
Health Net Orange Option 1 (PDP)

 |
$36.00 |
$320 |
No Gap Coverage |
No |
S5678 -022 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $83.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
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Humana Enhanced (PDP)

 |
$36.40 |
$0 |
No Gap Coverage |
No |
S5884 -066 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$38.90 |
$0 |
No Gap Coverage |
No |
S5820 -007 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $92.00 Specialty Tier Drugs: 33%
| 3874
Browse Formulary |
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HealthSpring Prescription Drug Plan -Reg 8 (PDP)

 |
$43.70 |
$320 |
No Gap Coverage |
No |
S5932 -008 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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MedicareRx Rewards Standard (PDP)

 |
$49.10 |
$320 |
No Gap Coverage |
No |
S5960 -114 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $32.00 Non-Preferred Brand Drugs: $85.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
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United American - Preferred (PDP)

 |
$53.50 |
$80 |
No Gap Coverage |
No |
S5755 -011 | 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
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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 Medicare Rx Standard (PDP)

 |
$66.10 |
$50 |
No Gap Coverage |
No |
S5540 -002 | Preferred Generic Drugs: $10.00 Non-Preferred Generic Drugs: $25.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 31%
| 3960
Browse Formulary |
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CIGNA Medicare Rx Plan Two (PDP)

 |
$66.60 |
$0 |
Few Generics |
No |
S5617 -178 | 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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Rite Aid EnvisionRxPlus (PDP)

 |
$69.20 |
$0 |
Some Generics |
No |
S7694 -079 | 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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WellCare Signature (PDP)

 |
$74.40 |
$0 |
No Gap Coverage |
No |
S5967 -042 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 2724
Browse Formulary |
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Community CCRx Choice (PDP)

 |
$75.90 |
$0 |
No Gap Coverage |
No |
S5803 -145 | 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 Value Orange Option 2 (PDP)

 |
$76.00 |
$0 |
No Gap Coverage |
No |
S5678 -021 | 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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| 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)

 |
$86.50 |
$0 |
No Gap Coverage |
No |
S5601 -017 | 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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Aetna Medicare Rx Premier (PDP)

 |
$87.40 |
$0 |
Many Generics |
No |
S5810 -178 | 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)

 |
$88.20 |
$0 |
Some Generics |
No |
S5921 -113 | 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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MedicareRx Rewards Plus (PDP)

 |
$90.80 |
$0 |
Some Generics |
No |
S5960 -145 | 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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Blue Medicare Rx Enhanced (PDP)

 |
$92.50 |
$0 |
Many Generics |
No |
S5540 -004 | Preferred Generic Drugs: $7.00 Non-Preferred Generic Drugs: $25.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33%
| 3960
Browse Formulary |
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First Health Part D Premier Plus (PDP)

 |
$105.00 |
$0 |
Some Generics and Some Brands |
No |
S5670 -048 | 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)

 |
$113.00 |
$0 |
Many Generics and Some Brands |
No |
S5884 -036 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $72.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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