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 -113 | 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)

 |
$25.20 |
$0 |
No Gap Coverage |
No |
S5768 -153 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 33%
| 3220
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Windsor Rx (PDP)

 |
$31.10 |
$320 |
No Gap Coverage |
Yes |
S4802 -020 | Generic Drugs: $6.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25%
| 2753
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First Health Part D Premier (PDP)

 |
$31.20 |
$250 |
No Gap Coverage |
Yes |
S5768 -123 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 37% Specialty Tier Drugs: 26%
| 3247
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CVS Caremark Value (PDP)

 |
$32.30 |
$320 |
No Gap Coverage |
Yes |
S5601 -060 | Generic Drugs: $5.25 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
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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 |
EnvisionRxPlus Silver (PDP)

 |
$32.70 |
$320 |
No Gap Coverage |
Yes |
S7694 -030 | 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)

 |
$33.40 |
$320 |
No Gap Coverage |
Yes |
S5803 -099 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25%
| 3019
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 |
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Humana Enhanced (PDP)

 |
$35.10 |
$0 |
No Gap Coverage |
No |
S5884 -028 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 4004
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Health Net Orange Option 1 (PDP)

 |
$35.80 |
$320 |
No Gap Coverage |
Yes |
S5678 -006 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $81.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
Browse Formulary |
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HealthSpring Prescription Drug Plan-Reg 30 (PDP)

 |
$35.90 |
$320 |
No Gap Coverage |
Yes |
S5932 -029 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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WellCare Classic (PDP)

 |
$36.00 |
$320 |
No Gap Coverage |
Yes |
S5967 -167 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 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 |
AARP MedicareRx Preferred (PDP)

 |
$41.90 |
$0 |
No Gap Coverage |
No |
S5820 -029 | 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
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United American - Select (PDP)

 |
$42.20 |
$320 |
No Gap Coverage |
No |
S5755 -101 | 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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Medco Medicare Prescription Plan - Value (PDP)

 |
$43.10 |
$320 |
No Gap Coverage |
No |
S5660 -132 | 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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MedicareRx Rewards Standard (PDP)

 |
$48.60 |
$320 |
No Gap Coverage |
No |
S5960 -136 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
Browse Formulary |
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CIGNA Medicare Rx Plan One (PDP)

 |
$49.00 |
$320 |
No Gap Coverage |
No |
S5617 -148 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $81.00 Specialty Tier Drugs: 25%
| 3582
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United American - Preferred (PDP)

 |
$51.30 |
$70 |
No Gap Coverage |
No |
S5755 -033 | 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 |
Aetna Medicare Rx Essentials (PDP)

 |
$52.10 |
$320 |
No Gap Coverage |
No |
S5810 -064 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $16.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 25%
| 3548
Browse Formulary |
| -- |
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Rite Aid EnvisionRxPlus (PDP)

 |
$66.70 |
$0 |
Some Generics |
No |
S7694 -100 | 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)

 |
$70.90 |
$0 |
No Gap Coverage |
No |
S5967 -064 | 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
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Asuris Medicare Script Basic (PDP)

 |
$74.50 |
$195 |
No Gap Coverage |
No |
S5609 -001 | Preferred Generic Drugs: $7.50 Non-Preferred Generic Drugs: $33.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 28% Injectable Drugs: 28%
| 4514
Browse Formulary |
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 |
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CVS Caremark Plus (PDP)

 |
$78.30 |
$0 |
No Gap Coverage |
No |
S5601 -061 | 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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Health Net Orange Option 2 (PDP)

 |
$82.30 |
$0 |
No Gap Coverage |
No |
S5678 -012 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $75.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 5170
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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)

 |
$83.70 |
$0 |
No Gap Coverage |
No |
S5803 -167 | 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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Aetna Medicare Rx Premier (PDP)

 |
$87.10 |
$0 |
Many Generics |
No |
S5810 -200 | 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)

 |
$91.90 |
$0 |
Some Generics |
No |
S5921 -023 | 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)

 |
$92.90 |
$0 |
Some Generics |
No |
S5960 -159 | 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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First Health Part D Premier Plus (PDP)

 |
$102.00 |
$0 |
Some Generics and Some Brands |
No |
S5674 -047 | 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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Asuris Medicare Script Enhanced (PDP)

 |
$106.50 |
$0 |
Many Generics |
No |
S5609 -002 | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $33.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 33% Injectable Drugs: 33%
| 4514
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)

 |
$118.70 |
$0 |
Many Generics and Some Brands |
No |
S5884 -058 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $71.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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