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STAND-ALONE DRUG PLANS

WhatÕs in this chart

Monthly premiums: What you pay for coverage.

Deductible: What you pay for drugs

before coverage kicks in

Low estimated cost: What Medicare

estimates Pinellas residents ages

65-69 in very good health will spend.

High estimated cost: What Medicare estimates Pinellas residents ages 80 to 84 in fair health will spend.

Generics in gap: Whether the plan pays for generics in the coverage gap.

Drug copayments: What you pay for drugs before the coverage gap kicks in. Figures are for 30-day retail supply. "PÕÕ means "preferred.ÕÕ Plans group drugs in "tiers,ÕÕ which vary from plan to plan.

Generics in gap: Whether or not a plan pays for generic drugs in the coverage

gap, which begins when total drug costs

hit $2,700 and ends when your out-of-pocket expenses hit $4,350.

WhatÕs not in this chart

Your exact cost: High and low estimated usage costs are estimates. To find your exact cost under each plan, use MedicareÕs

computerized drug plan finder.

Catastrophic coverage: After your

out-of-pocket expenses for drugs total

$4,350, most copayments drop dramatically

in all plans. These are not listed.

Drug formularies: One plan may carry your drug as a preferred brand, other plans may not. Some plans impose restrictions. Formularies are available at www.medicare.gov.

Plan ratings: Medicare monitors consumer satisfaction, but the ratings on different plans arenÕt yet available. You can find them after Nov. 15 on www.medicare.gov.

Company Plan Monthly premium Deduct- ible Est. cost (low) Est. cost (high) Generics in gap? Drug copayments
Aetna Medicare 1-800-529-5586 www.aetnamedicare.com Rx Essentials Rx-Costco Plus Rx Premier $46.60 $58.60 $111.30 $200 $0 $0 $1,050 $1,050 $1,650 $1,700 $1,500 $2,150 No Some Many P generic $0, generic $14, P brand $32, brand $74, specialty 25% P generic $0, generic $5, P brand $35, brand $90, specialty 33% P generic $0, generic $10, P brand $30, brand $65, specialty 33%
Blue Cross and Blue Shield of Florida 1-800-239-4280 www.bcbsfl.com BlueMedicare Rx-Option 3 BlueMedicare Rx-Option 1 BlueMedicare Rx-Option 2 $32.90 $56.70 $88.60 $200 $0 $0 $750 $1,000 $1,400 $1,250 $1,450 $1,800 No No Many Generic $0, P brand $45, brand $90, specialty 25% Generic $0, P brand $40, brand $83, specialty 33% Generic $0, P brand $40, brand $83, specialty 33%
Bravo Health 1-800-723-9209 www.mybravohealth.com BravoRx $23.60 $295 $750 $1,300 No All 3 tiers 25%
CIGNA Medicare Rx 1-800-735-1459 www.cignamedicarerx.com Rx Plan Two Rx Plan One Rx Plan Three $41.70 $42.00 $66.20 $0 $295 $0 $850 $900 $1,150 $1,350 $1,450 $1,650 No No Some Tier 1 $0, Tier 2 $6, Tier 3 $36, Tier 4, $80, Tier 5 33% Tier 1 $2.50, Tier 2 $28, Tier 3 $71, Tier 4 25% Tier 1 $6, Tier 2 $35, Tier 3 $60, Tier 4 33%
Citrus Health Care 1-866-769-1157 www.citrushc.com Citrus Part D Fl Citrus Part D Plus Fl $20.80 $42.00 $295 $0 $700 $850 $1,200 $1,300 No Some P generic $0, generic $5, P brand $25, brand $70, specialty 25% P generic $0, generic $5, P brand $30, brand $65, specialty 33%
Coventry AdvantraRx 1-800-882-3822 www.advantrarx.com Value Premier Premier Plus $23.00 $37.80 $55.40 $0 $0 $0 $650 $800 $1,000 $1,150 $1,300 $1,450 No No Many P generic $8, generic $56, P brand $24, brand $56, specialty 33% P generic $5, generic $65, P brand $30, brand $65, specialty 33% P generic $4, generic $70, P brand $29, brand $70, specialty 33 %
EnvisionRx Plus 1-866-250-2005 www.envisionrxplus.com Silver Gold $30.80 $73.50 $295 $0 $900 $1,200 $1,450 $1,650 No No P generic $4, generic $30, P brand $20, brand $75, specialty 25% P generic $0, generic $45, P brand $40, brand $75, specialty 33%
First Health Part D 1-800-588-3322 www.firsthealthpartd.com Secure Premier $16.70 $22.90 $175 $0 $600 $650 $1,100 $1,150 No No P generic $4, generic $48, P brand $20, brand $48, specialty 28% P generic $7, generic $51, P brand $25, brand $51, specialty 33%
Fox Insurance Co. 1-888-369-7979 www.foxrxcare.com Value Plan Grand Plan $16.80 $38.90 $295 $285 $800 $1,000 $1,500 $1,600 No Some Tier 1 $0, Tier 2 $27, Tier 3 $34, Tier 4 $75, Tier 5 25% Tier 1 $0, Tier 2 $19, Tier 3 $35, Tier 4 $75, Tier 5 25%
Health Net 1-800-606-3604 www.healthnet.com Orange Option 1 Orange Option 2 $29.70 $56.30 $295 $0 $850 $1,050 $1,450 $1,500 No No P generic $2, P brand $43 brand $90, injectable 25% P generic $5, P brand $30, brand $90 injectable 33%
HealthSpring PDP 1-800-331-6293 www.healthspring.com Prescription Drug Plan Ñ Reg.11 $27.60 $295 $800 $1,350 No Tiers 1 and 2 25%
Humana Insurance Co. 1-866-205-0000 www.humanamedicare.com PDP Standard PDP Enhanced PDP Complete $38.90 $43.10 $95.70 $295 $0 $0 $900 $900 $1,500 $1,400 $1,400 $2,000 No No Many P generic 15%, generic 40%, P brand 25%, brand 40% P generic $7, P brand $40 brand $70, specialty 33% P generic $7, P brand $40, brand $70, specialty 33%
Medco Medicare Prescription Plan 1-800-758-3605 www.medcomedicare.com Value Choice Access $32.40 $42.70 $70.90 $295 $0 $0 $850 $850 $1,200 $1,350 $1,350 $1,650 No No Many Generic 23%, P brand 23%, brand 53%, specialty 25% Generic $6, P brand $38, brand 75%, specialty 33% Generic $6, P brand $35, brand 75%, specialty 33%
Pennsylvania Life Insurance Co. 1-800-807-9990 www.prescribarx.com Prescriba Rx Bronze Prescriba Rx Gold Prescriba Rx Platinum $20.90 $39.70 $66.80 $295 $0 $0 $700 $900 $1,200 $1,250 $1,400 $1,700 No No All Generic 25%, brand 25%, specialty 25% Generic $6, brand $44, specialty 33% Generic $6, brand $44, specialty 33%
Quality Health Plans 1-866-747-9017 www.qualityhealthplans.com Quality Rx Quality Rx Plus $69.00 $79.90 $0 $0 $1,250 $1,350 $1,800 $1,850 No Many* Tier 1 $5, Tier 2 $25, Tier 3 $70, Tier 4 40%, Tier 5 25% Tier 1 $5, Tier 2 $25, Tier 3 $50, Tier 4 $75, Tier 5 33%
RxAmerica 1-800-429-6686 www.meds4medicare.com Advantage Star Plan Advantage Freedom Plan $21.50 $32.50 $295 $0 $700 $750 $1,300 $1,300 No No P generic $5.25, generic 45%, P brand 25%, brand 45%, specialty 25% P generic $5, generic 45%, P brand 35%, brand 45%, specialty 33%
SilverScript Insurance Co. 1-866-552-6106 www.silverscript.com Value Plus Complete $35.10 $46.40 $64.20 $295 $50.00 $0 $1,150 $1,150 $1,350 $1,400 $1,400 $1,600 No Many Many Generic $8, P brand $38.50, brand $98, specialty 25% Value generic $4, generic $9, value brand $30, P brand $35, brand $95, specialty 31% Value generic $2.50, generic $7.50, P brand $39, brand $98, specialty 33%
Sterling Life Insurance Co. 1-888-909-1713 www.sterlingplans.com Sterling Rx $33.90 $295 $850 $1,450 No Generic $7, P brand $25, brand $58, specialty 25%
Unicare 1-866-497-3981 www.unicare.com/medicare MedicareRx Rewards Standard MedicareRX Rewards Value $21.30 $25.10 $295 $130 $750 $750 $1,350 $1,300 No No All 5 tiers 25% P generic $9, generic $85, P brand $41, brand $85, specialty 29%
United American Insurance Co. 1-866-524-4169 www.uamedicarepartd.com UA Medicare Part D Silver plan UA Medicare Part D Prescription Drug Coverage $43.00 $50.00 $125 $0 $950 $900 $1,500 $1,400 No No Generic $4, P brand $40, brand $80, specialty 25% Generic $6, P brand $32, brand $64, specialty 33%
UnitedHealthcare 1-866-255-4835 aarpmedicarerx.com 1-866-498-9693 www.unitedhealthrx.com. AARP MedicareRx Saver AARP MedicareRx Preferred AARP MedicareRx Enhanced United-Healthcare Rx Basic $31.60 $32.50 $67.70 $37.00 $295 $0 $0 $0 $800 $750 $1,200 $850 $1,300 $1,250 $1,700 $1,350 No No Many No P generic $5, generic and P brand $22, other generic and brand $54.30, specialty 25% P generic $7, generic and P brand $38, other generic and brand $74.80, specialty 33% P generic $7, generic and P brand $39, other generic and brand $95, specialty 33% P generic $7, generic and P brand $35, other generic and brand $98, specialty 33%
Universal American 1-866-423-5040 www.communityccrx.com Community CCRx Basic Community CCRx Choice Community CCRx Gold $37.60 $50.00 $69.60 $295 $0 $0 $900 $950 $1,200 $1,400 $1,450 $1,650 No No All Generic $0, P brand 25%, brand 50% Generic $5, P brand $30, brand $60, specialty 33% Generic $5, P brand $30, brand $60, specialty 33%
WellCare 1-888-423-5252 www.wellcarepdp.com Classic Signature $24.00 $26.20 $295 $0 $700 $700 $1,200 $1,200 No No Tier 1 $0, Tier 2 $33, Tier 3 $78, Tier 4 25% Tier 1 $0, Tier 2 $39, Tier 3 $79, Tier 4 33%

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