A Healthy CollaborationSM

2009 Plans

PrescribaRxSM offers affordable plans and a network of more than 59,000 pharmacies nationwide, including major chains and mail-order. Our plans come with real savings: you can get a three-month supply of your medicines for the cost of two co-pays.

What plan is right for you?

Compare your Medicare Part D Prescription Drug plan options below. For more detailed information, review the Summary of Benefits.

Bronze
Gold
Platinum
Monthly Premium As low as $18.00 As low as $31.40 As low as $63.80
PART D PRESCRIPTION DRUG COVERAGE
Deductible $295 $0 $0
Initial Drug Coverage up to $2700 up to $2700 up to $2700
  34-day/90-day supply, you pay
Generics 25% coinsurance $6/$12 $6/$12
Brand 25% coinsurance $44/$88 $44/$88
Specialty Drugs 25% coinsurance 33% coinsurance 33% coinsurance
Coverage Gap Benefits No coverage No coverage $6/$12 for generics
Catastrophic Coverage: Amount you pay for prescriptions after your out-of-pocket prescription drug costs reach $4350
Generics The greater of 5% coinsurance or $2.40 The greater of 5% coinsurance or $2.40 The greater of 5% coinsurance or $2.40
Brand The greater of 5% coinsurance or $6.00 The greater of 5% coinsurance or $6.00 The greater of 5% coinsurance or $6.00

 

S5597S5825_C0008_web09d (01/2009) Last updated: 1/1/2022

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