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 -134 | 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 -132 | 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 -043 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $10.00 Preferred brand name drugs: $36.00 Non-preferred brand name drugs: 41% Specialty drugs: 25%
| 3548
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| -- |
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EnvisionRxPlus Silver (PDP)

 |
$30.60 |
$320 |
No Gap Coverage |
Yes |
S7694 -009 | 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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Health Net Orange Option 1 (PDP)

 |
$31.00 |
$320 |
No Gap Coverage |
Yes |
S5678 -024 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $89.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
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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)

 |
$33.60 |
$320 |
No Gap Coverage |
Yes |
S5617 -218 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $83.00 Specialty Tier Drugs: 25%
| 3582
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United American - Select (PDP)

 |
$34.10 |
$320 |
No Gap Coverage |
Yes |
S5755 -080 | 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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Community CCRx Basic (PDP)

 |
$34.40 |
$320 |
No Gap Coverage |
Yes |
S5803 -078 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 48% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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Windsor Rx (PDP)

 |
$34.60 |
$320 |
No Gap Coverage |
Yes |
S2505 -007 | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 25%
| 2753
Browse Formulary |
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First Health Part D Premier (PDP)

 |
$35.60 |
$250 |
No Gap Coverage |
Yes |
S5768 -012 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 21% Non-Preferred Brand Drugs: 37% Specialty Tier Drugs: 26%
| 3247
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CVS Caremark Value (PDP)

 |
$36.10 |
$320 |
No Gap Coverage |
Yes |
S5601 -018 | Generic Drugs: $6.00 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 |
Medco Medicare Prescription Plan - Value (PDP)

 |
$36.80 |
$320 |
No Gap Coverage |
Yes |
S5660 -111 | 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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HealthSpring Prescription Drug Plan -Reg 9 (PDP)

 |
$37.90 |
$320 |
No Gap Coverage |
Yes |
S5932 -009 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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BravoRx (PDP)

 |
$38.30 |
$320 |
No Gap Coverage |
No |
S5998 -018 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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WellCare Classic (PDP)

 |
$39.60 |
$320 |
No Gap Coverage |
No |
S5967 -146 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25%
| 2724
Browse Formulary |
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MedicareRx Rewards Standard (PDP)

 |
$39.90 |
$320 |
No Gap Coverage |
No |
S5960 -115 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $32.00 Non-Preferred Brand Drugs: $80.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
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AARP MedicareRx Preferred (PDP)

 |
$40.00 |
$0 |
No Gap Coverage |
No |
S5820 -008 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $94.00 Specialty Tier Drugs: 33%
| 3874
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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 |
MedBlue Rx (PDP)

 |
$42.80 |
$280 |
No Gap Coverage |
No |
S5953 -001 | Generic Drugs: $5.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 25%
| 3216
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Humana Enhanced (PDP)

 |
$47.70 |
$0 |
No Gap Coverage |
No |
S5884 -008 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $73.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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United American - Preferred (PDP)

 |
$52.20 |
$120 |
No Gap Coverage |
No |
S5755 -012 | 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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CIGNA Medicare Rx Plan Two (PDP)

 |
$61.60 |
$0 |
Few Generics |
No |
S5617 -179 | 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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WellCare Signature (PDP)

 |
$63.80 |
$0 |
No Gap Coverage |
No |
S5967 -043 | 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
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Rite Aid EnvisionRxPlus (PDP)

 |
$66.20 |
$0 |
Some Generics |
No |
S7694 -080 | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: 20% Preferred Brand Drugs: 15% Non-Preferred Brand Drugs: 30% Specialty Tier Drugs: 33%
| 2563
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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)

 |
$66.30 |
$0 |
No Gap Coverage |
No |
S5678 -023 | 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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MedBlue Rx Plus (PDP)

 |
$76.50 |
$0 |
Many Generics |
No |
S5953 -002 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $33.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 33%
| 3216
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CVS Caremark Plus (PDP)

 |
$76.70 |
$0 |
No Gap Coverage |
No |
S5601 -019 | 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)

 |
$77.30 |
$0 |
No Gap Coverage |
No |
S5803 -146 | 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)

 |
$86.50 |
$0 |
Some Generics |
No |
S5921 -123 | 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)

 |
$86.70 |
$0 |
Some Generics |
No |
S5960 -146 | 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 |
Aetna Medicare Rx Premier (PDP)

 |
$89.00 |
$0 |
Many Generics |
No |
S5810 -179 | 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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First Health Part D Premier Plus (PDP)

 |
$104.60 |
$0 |
Some Generics and Some Brands |
No |
S5670 -054 | 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)

 |
$112.00 |
$0 |
Many Generics and Some Brands |
No |
S5884 -037 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $69.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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