2014 Medicare Part D Plan Information Click here to jump to the Chart Legend & Search Tips | ||||||||
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Plan Name | Monthly Prem. |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
$0 Prem. with Full LIS? |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
Total Formulary Drugs | ||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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Humana Walmart Rx Plan (PDP) - S5884-178 Benefit Details |
$12.60 | $310 | No additional gap coverage, only the Donut Hole Discount | No | Preferred Generic: $1.00 Non-Preferred Generic: $4.00 Preferred Brand: 20% Non-Preferred Brand: 39% Specialty Tier: 25% | 3,310 Browse Formulary | ||
Higher cost-sharing at standard network pharmacies Details: | ||||||||
WellCare Classic (PDP) - S5967-169 Benefit Details |
$22.40 | $0 | No additional gap coverage, only the Donut Hole Discount | Yes | Preferred Generic: $0.00 Non-Preferred Generic: $15.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | 2,986 Browse Formulary | ||
Higher cost-sharing at standard network pharmacies Details: | ||||||||
Plan Name | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
$0 Prem LIS? |
Preferred Pharmacy Copay/ Coinsurance |
Total Drugs | ||
Service | Exper. | Cost Info | ||||||
Humana Preferred Rx Plan (PDP) - S5884-114 Benefit Details |
$22.80 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | Preferred Generic: $1.00 Non-Preferred Generic: $2.00 Preferred Brand: 20% Non-Preferred Brand: 35% Specialty Tier: 25% | 3,183 Browse Formulary | ||
Higher cost-sharing at standard network pharmacies Details: | ||||||||
Symphonix Rite Aid Value Rx (PDP) - S0522-034 Benefit Details |
$23.80 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | Preferred Generic: $1.00 Non-Preferred Generic: $10.00 Preferred Brand: $38.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | 3,552 Browse Formulary | ||
new | new | new | Higher cost-sharing at standard network pharmacies Details: | |||||
HealthMarkets Value Rx (PDP) - S0128-033 Benefit Details |
$24.50 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | Preferred Generic: $0.00 Non-Preferred Generic: $2.00 Preferred Brand: 25% Non-Preferred Brand: 40% Specialty Tier: 25% | 3,098 Browse Formulary | ||
-- | -- | Higher cost-sharing at standard network pharmacies Details: |
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