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 -139 | 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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Aetna CVS/pharmacy Prescription Drug Plan (PDP)

 |
$26.00 |
$320 |
No Gap Coverage |
Yes |
S5810 -050 | Preferred generic drugs: $3.00 Non-preferred generic drugs: $10.00 Preferred brand name drugs: $28.00 Non-preferred brand name drugs: 39% Specialty drugs: 25%
| 3548
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| -- |
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First Health Part D Value Plus (PDP)

 |
$28.10 |
$0 |
No Gap Coverage |
No |
S5768 -139 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 39% Specialty Tier Drugs: 33%
| 3220
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CIGNA Medicare Rx Plan One (PDP)

 |
$32.90 |
$320 |
No Gap Coverage |
Yes |
S5617 -223 | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $20.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 25%
| 3582
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First Health Part D Premier (PDP)

 |
$34.50 |
$250 |
No Gap Coverage |
Yes |
S5768 -083 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: 21% Non-Preferred Brand Drugs: 36% 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 |
Community CCRx Basic (PDP)

 |
$34.90 |
$320 |
No Gap Coverage |
Yes |
S5803 -085 | Generic Drugs: $2.00 Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 47% Specialty Tier Drugs: 25%
| 3019
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EnvisionRxPlus Silver (PDP)

 |
$35.20 |
$320 |
No Gap Coverage |
Yes |
S7694 -016 | 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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CVS Caremark Value (PDP)

 |
$35.40 |
$320 |
No Gap Coverage |
Yes |
S5601 -032 | Generic Drugs: $5.50 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25%
| 3044
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United American - Select (PDP)

 |
$35.90 |
$320 |
No Gap Coverage |
Yes |
S5755 -087 | 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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Health Net Orange Option 1 (PDP)

 |
$36.90 |
$320 |
No Gap Coverage |
Yes |
S5678 -038 | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 4297
Browse Formulary |
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Humana Enhanced (PDP)

 |
$37.90 |
$0 |
No Gap Coverage |
No |
S5884 -074 | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $76.00 Specialty Tier Drugs: 33%
| 4004
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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 16 (PDP)

 |
$38.50 |
$320 |
No Gap Coverage |
Yes |
S5932 -015 | Tier 1: 25% Tier 2: 25%
| 3167
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AARP MedicareRx Preferred (PDP)

 |
$41.30 |
$0 |
No Gap Coverage |
No |
S5820 -015 | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $9.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33%
| 3874
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Blue MedicareRx Standard (PDP)

 |
$45.70 |
$320 |
No Gap Coverage |
No |
S5596 -056 | Preferred Generic Drugs: $2.00 Non-Preferred Generic Drugs: $8.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $90.00 Injectable Drugs: 25% Specialty Tier Drugs: 25%
| 3212
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Medco Medicare Prescription Plan - Value (PDP)

 |
$47.30 |
$320 |
No Gap Coverage |
No |
S5660 -118 | 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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WPS MedicareRx Plan 1 (PDP)

 |
$51.60 |
$200 |
No Gap Coverage |
No |
S5753 -006 | Preferred Generic Drugs: $6.00 Non-Preferred Generic Drugs: $13.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 28%
| 3440
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United American - Preferred (PDP)

 |
$53.20 |
$130 |
No Gap Coverage |
No |
S5755 -019 | 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: 29%
| 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 |
Blue MedicareRx Plus (PDP)

 |
$64.60 |
$0 |
Some Generics |
No |
S5596 -057 | 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)

 |
$75.80 |
$0 |
No Gap Coverage |
No |
S5678 -037 | Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $32.00 Non-Preferred Brand Drugs: $64.00 Injectable Drugs: 33% Specialty Tier Drugs: 33%
| 4297
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Aetna Medicare Rx Premier (PDP)

 |
$76.60 |
$0 |
Many Generics |
No |
S5810 -186 | 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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EnvisionRxPlus Gold (PDP)

 |
$78.20 |
$0 |
Some Generics |
No |
S7694 -086 | 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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Medco Medicare Prescription Plan - Choice (PDP)

 |
$81.70 |
$150 |
Many Generics |
No |
S5660 -186 | 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
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Community CCRx Choice (PDP)

 |
$84.70 |
$0 |
No Gap Coverage |
No |
S5803 -153 | 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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| Plan Name |
Monthly Prem. |
Deduct- ible |
Gap Coverage |
$0 Prem LIS? |
Plan ID |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs |
| Service |
Exper. |
CostInfo |
CVS Caremark Plus (PDP)

 |
$87.60 |
$0 |
No Gap Coverage |
No |
S5601 -033 | 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)

 |
$93.20 |
$0 |
Some Generics |
No |
S5921 -073 | 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)

 |
$103.70 |
$0 |
Some Generics and Some Brands |
No |
S5670 -084 | 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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Humana Complete (PDP)

 |
$109.20 |
$0 |
Many Generics and Some Brands |
No |
S5884 -044 | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $73.00 Specialty Tier Drugs: 33%
| 4004
Browse Formulary |
 |
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WPS MedicareRx Plan 2 (PDP)

 |
$111.20 |
$0 |
Many Generics |
No |
S5753 -007 | Preferred Generic Drugs: $6.00 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33%
| 3440
Browse Formulary |
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Blue MedicareRx Premier (PDP)

 |
$114.70 |
$0 |
Many Generics and Some Brands |
No |
S5596 -058 | 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
Browse Formulary |
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