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 -145 | Preferred Generic Drugs: $1.00 Non-Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 35%
| 3277
Browse Formulary |
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First Health Part D Value Plus (PDP)

 |
$25.10 |
$0 |
No Gap Coverage |
No |
S5768 -148 | 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 -059 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $10.00 Preferred brand name drugs: $31.00 Non-preferred brand name drugs: 40% Specialty drugs: 25%
| 3548
Browse Formulary |
| -- |
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First Health Part D Premier (PDP)

 |
$30.40 |
$250 |
No Gap Coverage |
Yes |
S5768 -122 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 36% Specialty Tier Drugs: 26%
| 3247
Browse Formulary |
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Windsor Rx (PDP)

 |
$33.00 |
$320 |
No Gap Coverage |
Yes |
S4802 -030 | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25%
| 2753
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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)

 |
$34.80 |
$320 |
No Gap Coverage |
Yes |
S5803 -094 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 48% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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EnvisionRxPlus Silver (PDP)

 |
$35.10 |
$320 |
No Gap Coverage |
Yes |
S7694 -025 | 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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CIGNA Medicare Rx Plan One (PDP)

 |
$35.40 |
$320 |
No Gap Coverage |
Yes |
S5617 -123 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 25%
| 3582
Browse Formulary |
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Humana Enhanced (PDP)

 |
$35.40 |
$0 |
No Gap Coverage |
No |
S5884 -083 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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CVS Caremark Value (PDP)

 |
$35.50 |
$320 |
No Gap Coverage |
Yes |
S5601 -050 | Generic Drugs: $5.75 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)

 |
$36.90 |
$320 |
No Gap Coverage |
Yes |
S5660 -127 | 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 |
HealthSpring Prescription Drug Plan-Reg 25 (PDP)

 |
$38.70 |
$320 |
No Gap Coverage |
No |
S5932 -024 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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United American - Select (PDP)

 |
$38.70 |
$320 |
No Gap Coverage |
No |
S5755 -096 | 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
Browse Formulary |
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BravoRx (PDP)

 |
$39.20 |
$320 |
No Gap Coverage |
No |
S5998 -029 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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WellCare Classic (PDP)

 |
$39.40 |
$320 |
No Gap Coverage |
No |
S5967 -162 | 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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MedicareBlue Rx Standard (PDP)

 |
$39.70 |
$160 |
No Gap Coverage |
No |
S5743 -001 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $10.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: 48%
| 2956
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$41.90 |
$0 |
No Gap Coverage |
No |
S5820 -024 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $95.00 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 |
Health Net Orange Option 1 (PDP)

 |
$50.60 |
$320 |
No Gap Coverage |
No |
S5678 -056 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $93.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
Browse Formulary |
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MedicareRx Rewards Standard (PDP)

 |
$52.50 |
$320 |
No Gap Coverage |
No |
S5960 -131 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $33.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
Browse Formulary |
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United American - Preferred (PDP)

 |
$56.30 |
$40 |
No Gap Coverage |
No |
S5755 -028 | 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: 32%
| 3499
Browse Formulary |
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CIGNA Medicare Rx Plan Two (PDP)

 |
$69.40 |
$0 |
Few Generics |
No |
S5617 -195 | 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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EnvisionRxPlus Gold (PDP)

 |
$70.80 |
$0 |
Some Generics |
No |
S7694 -095 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: 15% Preferred Brand Drugs: 15% Non-Preferred Brand Drugs: 30% Specialty Tier Drugs: 33%
| 2563
Browse Formulary |
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WellCare Signature (PDP)

 |
$72.00 |
$0 |
No Gap Coverage |
No |
S5967 -059 | 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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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
Health Net Value Orange Option 2 (PDP)

 |
$75.30 |
$0 |
No Gap Coverage |
No |
S5678 -055 | 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 |
 |
 |
 |
Aetna Medicare Rx Premier (PDP)

 |
$75.50 |
$0 |
Many Generics |
No |
S5810 -195 | 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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CVS Caremark Plus (PDP)

 |
$78.60 |
$0 |
No Gap Coverage |
No |
S5601 -051 | 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)

 |
$87.60 |
$0 |
No Gap Coverage |
No |
S5803 -162 | 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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AARP MedicareRx Enhanced (PDP)

 |
$91.30 |
$0 |
Some Generics |
No |
S5921 -249 | 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)

 |
$95.10 |
$0 |
Some Generics |
No |
S5960 -156 | 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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 |
 |
| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
Medco Medicare Prescription Plan - Choice (PDP)

 |
$97.80 |
$150 |
Many Generics |
No |
S5660 -195 | 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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First Health Part D Premier Plus (PDP)

 |
$100.90 |
$0 |
Some Generics and Some Brands |
No |
S5674 -035 | 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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MedicareBlue Rx Premier (PDP)

 |
$104.60 |
$0 |
All Generics |
No |
S5743 -004 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: 48%
| 2956
Browse Formulary |
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Humana Complete (PDP)

 |
$106.50 |
$0 |
Many Generics and Some Brands |
No |
S5884 -053 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $72.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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