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 -143 | 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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EnvisionRxPlus Silver (PDP)

 |
$22.90 |
$320 |
No Gap Coverage |
Yes |
S7694 -022 | 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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First Health Part D Value Plus (PDP)

 |
$23.20 |
$0 |
No Gap Coverage |
No |
S5768 -145 | 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 -056 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $10.00 Preferred brand name drugs: $33.00 Non-preferred brand name drugs: 39% Specialty drugs: 25%
| 3548
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| -- |
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CIGNA Medicare Rx Plan One (PDP)

 |
$26.70 |
$320 |
No Gap Coverage |
Yes |
S5617 -108 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $77.00 Specialty Tier Drugs: 25%
| 3582
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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 |
Windsor Rx (PDP)

 |
$28.20 |
$320 |
No Gap Coverage |
Yes |
S4802 -013 | Generic Drugs: $6.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25%
| 2753
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CVS Caremark Value (PDP)

 |
$28.30 |
$320 |
No Gap Coverage |
Yes |
S5601 -044 | Generic Drugs: $7.50 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
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Community CCRx Basic (PDP)

 |
$28.80 |
$320 |
No Gap Coverage |
Yes |
S5803 -091 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 45% Specialty Tier Drugs: 25%
| 3019
Browse Formulary |
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First Health Part D Premier (PDP)

 |
$29.10 |
$250 |
No Gap Coverage |
Yes |
S5768 -045 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 21% Non-Preferred Brand Drugs: 37% Specialty Tier Drugs: 26%
| 3247
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United American - Select (PDP)

 |
$29.70 |
$320 |
No Gap Coverage |
Yes |
S5755 -093 | 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
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BravoRx (PDP)

 |
$30.70 |
$320 |
No Gap Coverage |
Yes |
S5998 -039 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
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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)

 |
$30.70 |
$320 |
No Gap Coverage |
Yes |
S5967 -159 | 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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Health Net Orange Option 1 (PDP)

 |
$31.30 |
$320 |
No Gap Coverage |
Yes |
S5678 -050 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
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HealthSpring Prescription Drug Plan-Reg 22 (PDP)

 |
$31.30 |
$320 |
No Gap Coverage |
Yes |
S5932 -021 | Tier 1: 25% Tier 2: 25%
| 3167
Browse Formulary |
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Medco Medicare Prescription Plan - Value (PDP)

 |
$34.00 |
$320 |
No Gap Coverage |
No |
S5660 -124 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 35% Specialty Tier Drugs: 25%
| 3440
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Humana Enhanced (PDP)

 |
$39.90 |
$0 |
No Gap Coverage |
No |
S5884 -020 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $73.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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Blue MedicareRx Value (PDP)

 |
$44.10 |
$125 |
No Gap Coverage |
No |
S5715 -005 | Generic Drugs: $10.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $91.00 Specialty Tier Drugs: 29%
| 2956
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 |
MedicareRx Rewards Standard (PDP)

 |
$45.50 |
$320 |
No Gap Coverage |
No |
S5960 -128 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $90.00 Injectable Drug: 25% Specialty Tier Drugs: 25%
| 3212
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AARP MedicareRx Preferred (PDP)

 |
$45.60 |
$0 |
No Gap Coverage |
No |
S5820 -021 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 3874
Browse Formulary |
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United American - Preferred (PDP)

 |
$55.20 |
$110 |
No Gap Coverage |
No |
S5755 -025 | 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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WellCare Signature (PDP)

 |
$60.30 |
$0 |
No Gap Coverage |
No |
S5967 -056 | 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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EnvisionRxPlus Gold (PDP)

 |
$61.20 |
$0 |
Some Generics |
No |
S7694 -092 | 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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CIGNA Medicare Rx Plan Two (PDP)

 |
$74.20 |
$0 |
Few Generics |
No |
S5617 -192 | 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
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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)

 |
$75.10 |
$0 |
Many Generics |
No |
S5810 -192 | 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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Community CCRx Choice (PDP)

 |
$77.90 |
$0 |
No Gap Coverage |
No |
S5803 -159 | 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)

 |
$79.20 |
$0 |
No Gap Coverage |
No |
S5601 -045 | 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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AARP MedicareRx Enhanced (PDP)

 |
$85.40 |
$0 |
Some Generics |
No |
S5921 -193 | 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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Health Net Orange Option 2 (PDP)

 |
$86.30 |
$0 |
No Gap Coverage |
No |
S5678 -049 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $75.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 5170
Browse Formulary |
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MedicareRx Rewards Plus (PDP)

 |
$89.40 |
$0 |
Some Generics |
No |
S5960 -154 | 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 |
 |
 |
 |
| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
Blue MedicareRx Plus (PDP)

 |
$90.80 |
$0 |
All Generics |
No |
S5715 -006 | Generic Drugs: $5.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33%
| 2956
Browse Formulary |
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Medco Medicare Prescription Plan - Choice (PDP)

 |
$96.00 |
$150 |
Many Generics |
No |
S5660 -192 | 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)

 |
$104.20 |
$0 |
Some Generics and Some Brands |
No |
S5670 -120 | 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)

 |
$104.30 |
$0 |
Many Generics and Some Brands |
No |
S5884 -050 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $68.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
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