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 -104 | 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)

 |
$23.90 |
$0 |
No Gap Coverage |
No |
S5768 -129 | 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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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -040 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $21.00 Preferred brand name drugs: $35.00 Non-preferred brand name drugs: 40% Specialty drugs: 25%
| 3548
Browse Formulary |
| -- |
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Community CCRx Basic (PDP)

 |
$28.70 |
$320 |
No Gap Coverage |
Yes |
S5803 -075 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 46% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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CVS Caremark Value (PDP)

 |
$30.20 |
$320 |
No Gap Coverage |
Yes |
S5601 -012 | Generic Drugs: $5.00 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 |
CIGNA Medicare Rx Plan One (PDP)

 |
$31.70 |
$320 |
No Gap Coverage |
Yes |
S5617 -215 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $82.00 Specialty Tier Drugs: 25%
| 3582
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First Health Part D Premier (PDP)

 |
$32.70 |
$250 |
No Gap Coverage |
Yes |
S5768 -009 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: 19% Non-Preferred Brand Drugs: 35% Specialty Tier Drugs: 26%
| 3247
Browse Formulary |
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 |
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EnvisionRxPlus Silver (PDP)

 |
$33.10 |
$320 |
No Gap Coverage |
Yes |
S7694 -006 | 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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Medco Medicare Prescription Plan - Value (PDP)

 |
$33.40 |
$320 |
No Gap Coverage |
Yes |
S5660 -108 | 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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United American - Select (PDP)

 |
$33.50 |
$320 |
No Gap Coverage |
Yes |
S5755 -077 | 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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Health Net Orange Option 1 (PDP)

 |
$34.50 |
$320 |
No Gap Coverage |
Yes |
S5678 -018 | Preferred Generic Drugs: $4.00 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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| 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)

 |
$34.90 |
$320 |
No Gap Coverage |
Yes |
S5967 -143 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $92.00 Specialty Tier Drugs: 25%
| 2724
Browse Formulary |
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HealthSpring Prescription Drug Plan -Reg 6 (PDP)

 |
$35.20 |
$320 |
No Gap Coverage |
Yes |
S5932 -006 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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AARP MedicareRx Preferred (PDP)

 |
$36.60 |
$0 |
No Gap Coverage |
No |
S5820 -005 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $93.00 Specialty Tier Drugs: 33%
| 3874
Browse Formulary |
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BravoRx (PDP)

 |
$36.80 |
$320 |
No Gap Coverage |
No |
S5998 -005 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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Humana Enhanced (PDP)

 |
$38.10 |
$0 |
No Gap Coverage |
No |
S5884 -005 | 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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AmeriHealth Rx Option I (PDP)

 |
$42.10 |
$320 |
No Gap Coverage |
No |
S2321 -005 | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25%
| 3870
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 |
SecureRx - Option 3 (PDP)

 |
$45.10 |
$0 |
No Gap Coverage |
No |
S8067 -001 | Generic Drugs: $10.00 Preferred Brand Drugs: $51.00 Specialty Tier Drugs: 33%
| 2899
Browse Formulary |
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MedicareRx Rewards Standard (PDP)

 |
$45.80 |
$320 |
No Gap Coverage |
No |
S5960 -112 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $32.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
Browse Formulary |
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United American - Preferred (PDP)

 |
$50.90 |
$100 |
No Gap Coverage |
No |
S5755 -009 | 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: 30%
| 3499
Browse Formulary |
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BlueRx Plus (PDP)

 |
$58.70 |
$150 |
No Gap Coverage |
No |
S5593 -002 | Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 29%
| 5201
Browse Formulary |
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 |
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WellCare Signature (PDP)

 |
$58.80 |
$0 |
No Gap Coverage |
No |
S5967 -040 | 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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CIGNA Medicare Rx Plan Two (PDP)

 |
$65.40 |
$0 |
Few Generics |
No |
S5617 -176 | 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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| 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)

 |
$69.00 |
$0 |
No Gap Coverage |
No |
S5678 -017 | 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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Rite Aid EnvisionRxPlus (PDP)

 |
$69.70 |
$0 |
Some Generics |
No |
S7694 -077 | 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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 |
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Community CCRx Choice (PDP)

 |
$78.30 |
$0 |
No Gap Coverage |
No |
S5803 -143 | 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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CVS Caremark Plus (PDP)

 |
$82.50 |
$0 |
No Gap Coverage |
No |
S5601 -013 | 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)

 |
$86.10 |
$0 |
Many Generics |
No |
S5810 -176 | 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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AmeriHealth Rx Option II (PDP)

 |
$87.10 |
$0 |
Many Generics |
No |
S2321 -002 | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $10.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $65.00 Specialty Tier Drugs: 25%
| 5221
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)

 |
$87.50 |
$0 |
Some Generics |
No |
S5921 -093 | 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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Medco Medicare Prescription Plan - Choice (PDP)

 |
$88.90 |
$150 |
Many Generics |
No |
S5660 -176 | 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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MedicareRx Rewards Plus (PDP)

 |
$90.50 |
$0 |
Some Generics |
No |
S5960 -144 | 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)

 |
$98.70 |
$0 |
Some Generics and Some Brands |
No |
S5670 -036 | 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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Humana Complete (PDP)

 |
$109.40 |
$0 |
Many Generics and Some Brands |
No |
S5884 -034 | 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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 |
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BlueRx Complete (PDP)

 |
$114.40 |
$0 |
Many Generics |
No |
S5593 -003 | Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33%
| 5201
Browse Formulary |
 |
 |
 |
| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
SecureRx - Option 1 (PDP)

 |
$115.60 |
$0 |
Many Generics |
No |
S8067 -003 | Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $85.00 Specialty Tier Drugs: 33%
| 4879
Browse Formulary |
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