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 -132 | 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 -130 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 33%
| 3220
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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -041 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $16.00 Preferred brand name drugs: $35.00 Non-preferred brand name drugs: 40% Specialty drugs: 25%
| 3548
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| -- |
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EnvisionRxPlus Silver (PDP)

 |
$27.40 |
$320 |
No Gap Coverage |
Yes |
S7694 -007 | 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 Premier (PDP)

 |
$27.40 |
$250 |
No Gap Coverage |
Yes |
S5768 -010 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 20% Non-Preferred Brand Drugs: 37% Specialty Tier Drugs: 26%
| 3247
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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)

 |
$27.70 |
$320 |
No Gap Coverage |
Yes |
S5617 -216 | 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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Community CCRx Basic (PDP)

 |
$30.00 |
$320 |
No Gap Coverage |
Yes |
S5803 -076 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 47% Specialty Tier Drugs: 25%
| 3019
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United American - Select (PDP)

 |
$30.90 |
$320 |
No Gap Coverage |
Yes |
S5755 -078 | 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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CVS Caremark Value (PDP)

 |
$31.20 |
$320 |
No Gap Coverage |
Yes |
S5601 -014 | Generic Drugs: $5.50 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
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Blue MedicareRx Standard (PDP)

 |
$32.50 |
$320 |
No Gap Coverage |
Yes |
S5596 -005 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 3212
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Health Net Orange Option 1 (PDP)

 |
$33.00 |
$320 |
No Gap Coverage |
Yes |
S5678 -020 | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $83.00 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 |
HealthSpring Prescription Drug Plan -Reg 7 (PDP)

 |
$33.20 |
$320 |
No Gap Coverage |
No |
S5932 -007 | Tier 1: 25% Tier 2: 25%
| 3167
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WellCare Classic (PDP)

 |
$33.20 |
$320 |
No Gap Coverage |
No |
S5967 -144 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $91.00 Specialty Tier Drugs: 25%
| 2724
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AARP MedicareRx Preferred (PDP)

 |
$36.00 |
$0 |
No Gap Coverage |
No |
S5820 -006 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $92.00 Specialty Tier Drugs: 33%
| 3874
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Humana Enhanced (PDP)

 |
$37.60 |
$0 |
No Gap Coverage |
No |
S5884 -065 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $71.00 Specialty Tier Drugs: 33%
| 4004
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BravoRx (PDP)

 |
$38.00 |
$320 |
No Gap Coverage |
No |
S5998 -016 | Tier 1: 25% Tier 2: 25% Tier 3: 25%
| 3121
Browse Formulary |
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Medco Medicare Prescription Plan - Value (PDP)

 |
$41.40 |
$320 |
No Gap Coverage |
No |
S5660 -109 | 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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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
United American - Preferred (PDP)

 |
$47.60 |
$100 |
No Gap Coverage |
No |
S5755 -010 | 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
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WellCare Signature (PDP)

 |
$62.00 |
$0 |
No Gap Coverage |
No |
S5967 -041 | 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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CIGNA Medicare Rx Plan Two (PDP)

 |
$62.30 |
$0 |
Few Generics |
No |
S5617 -177 | 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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Blue MedicareRx Plus (PDP)

 |
$68.00 |
$0 |
Some Generics |
No |
S5596 -006 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 3443
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Health Net Value Orange Option 2 (PDP)

 |
$69.00 |
$0 |
No Gap Coverage |
No |
S5678 -019 | 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)

 |
$71.60 |
$0 |
Some Generics |
No |
S7694 -078 | 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 |
Aetna Medicare Rx Premier (PDP)

 |
$78.10 |
$0 |
Many Generics |
No |
S5810 -177 | 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
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| -- |
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Community CCRx Choice (PDP)

 |
$78.50 |
$0 |
No Gap Coverage |
No |
S5803 -144 | 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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CVS Caremark Plus (PDP)

 |
$85.80 |
$0 |
No Gap Coverage |
No |
S5601 -015 | 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)

 |
$86.30 |
$0 |
Some Generics |
No |
S5921 -103 | 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
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First Health Part D Premier Plus (PDP)

 |
$96.40 |
$0 |
Some Generics and Some Brands |
No |
S5670 -042 | 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
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Humana Complete (PDP)

 |
$107.40 |
$0 |
Many Generics and Some Brands |
No |
S5884 -035 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $72.00 Specialty Tier Drugs: 33%
| 4004
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 |
Blue MedicareRx Premier (PDP)

 |
$118.70 |
$0 |
Many Generics and Some Brands |
No |
S5596 -007 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 4669
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