Part D 2016 Medicare Prescription Drug Plans in Virginia Source - U.S. Department of Health and Human Services Center for Medicare & Medicaid Services CMS Publication No. 10050-33 - September 2015
Medicare PRESCRIPTION DRUG PLANS, in Virginia. ' This chart provides basic information about what your costs will be for each plan. See page 160 for information on how to read this chart. Contact the plan for specific details. Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to compare plans or look for a plan that isn't listed. TTY users should call 1-877-486-2048. See pages 18-19 for a list of things to consider when choosing a plan or to learn how to get personalized help with your choices. Aetna Medicare (S5810) www.aetnamedicare.com Aetna Medicare Rx Saver (PDP) (041) Phone: 855-338-7030 $26.40 $360 for all drugs $1 - $40 Copay and/or 25% - 41 % Coinsurance Anthem Blue Cross and Blue Shield (S5596) Members' Rating of Plan: 81% Anthem Blue MedicareRx Plus (PDP) (006) Phone: 800-261-8667 $75.30 $0 Anthem Blue MedicareRx Premier (PDP) (007) $124.50. $0 Phone:800-261-8667 Anthem Blue MedicareRx Standard (PDP) (005) $37.80 $360 some drugs; call plan Phone: 800-261-8667 $0 - $45 Copay and/or $0 - $45 Copay and/or 33% - 40% Coinsurance $0 - $47 Copay and/or www.anthem.com/shop $0 - $9 Copay and/or $0 - $17 Copay and/or 45% - 65% Coinsurance Cigna-HealthSpring Rx (S5617) www.cignahealthspring.com Cigna-HealthSpring Rx Secure (PDP) (216) Phone: 800-735-1459 Cigna-HealthSpring Rx Secure-Extra (PDP) (252) Phone:800-735-1459 $47.20 $360 for all drugs $49.20 $250 for all drugs $3 - $11 Copay and/or 16% - 50% Coinsurance 20% - 50% Coinsurance : If you qualify for Extra Help, your monthly premium and the amount you pay for each prescription may be less than the amounts listed in these columns. Contact the plan for specific formulary (list of covered dmgs) and cost information. If you qualify for the full Extra Help and the premium amount is BLUE, ON
EnvisionRx Plus (S7694) www.envisionrxplus.com EnvisionRxPlus Silver (PDP) (007) Phone: 866-250-2005 $30.70 $360 for all drugs $2 - $10 Copay and/or 10% - 45% Coinsurance Express Scripts Medicare (S5660) Members' Rating of Plan: 86% www.express-scriptsmedicare.com Express Scripts Medicare - Choice (PDP) (217) Phone: 866-477-5704 $76.90 $360 some drugs; call plan $1 - $47 Copay and/or Express Scripts Medicare - Value (PDP) (109) Phone: 866-477-5704 $56.20 $360 for all drugs $0 - $15 Copay and/or 21% - 50% Coinsurance First Health Part D (S5768) www.firsthealthpartd.com First Health Part D Premier Plus (PDP) (166) Phone: 855-389-9688 $70.40 $0 $1 - $40 Copay and/or $1 - $7 Copay and/or First Health Part D Value Plus (PDP) (130) Phone: 855-389-9688 $33.90 $0 $1 - $47 Copay and/or Humana Insurance Company (S5884) Members' Rating of Plan: 82% www.humana-medicare.com Humana Enhanced (PDP) (065) $64.90 $0 $3 - $47 Copay and/or $42 - $95 Copay and/or Humana Preferred Rx Plan (PDP) (132) $28 $360 for all drugs $1 - $6 Copay and/or 20% - 40% Coinsurance Humana Walmart Rx Plan (PDP) (153) $18.40 $360 some drugs; call plan 20% - 50% Coinsurance
Magellan Rx Medicare (S4607) Plan too new for rating Magellan Rx Medicare Basic (PDP) (009) Phone: 800-424-5759 $32.20 $360 for all drugs $1 - $100 Copay and/or 25% Coinsurance medicare.magellanrx.com SilverScript (S5601) Members" Rating of Plan: 83% SilverScript Choice (PDP) (014) Phone: 866-552-6106 SilverScript Plus (PDP) (015) Phone: 866-552-6106 $23.40 $0 $82.50 $0 $3 - $46 Copay and/or 33% - 46% Coinsurance $0 - $29 Copay and/or www.silverscript.com $0 - $10 Copay and/or Stonebridge Life Insurance Company (S9579) Members' Rating of Plan: 84% Transamerica MedicareRx Classic (PDP) (006) $118.20 $360 for all drugs Phone: 877-527-1958 WWW transamericamedicarerx.com $0 - $8 Copay and/or 25% - 39% Coinsurance Symphonix Health (S0522) Members' Rating of Plan: 79% Symphonix PrimeSaver Rx (PDP) (052) Phone: 855-355-2280 Symphonix Value Rx (PDP) (008) Phone: 855-355-2280 $40.10 $200 some drugs; call plan $28 $360 for all drugs $1 - $11 Copay and/or 20% - 43% Coinsurance $1 - $3 Copay and/or 20% - 35% Coinsurance www.symphonixhealth.com UnitedHealthcare (S5820) www.aarpmedicarerx.com AARP MedicareRx Preferred (PDP) (006) Phone: 888-867-5564 $60.30 $0 $2 - $47 Copay and/or
UnitedHealthcare (S5921) Members' Rating of Plan: 79% www.aarpmedicarerx.com MRP MedicareRx Saver Plus (PDP) (352) Phone: 888-867-5564 $39 $360 for all drugs $1 - $38 Copay and/or 25% - 40% Coinsurance WellCare (S2505) www.wellcarepdp.com WellCare Simple (PDP) (009) Phone: 888-900-4307 $37.10 $0 $8 - $47 Copay and/or WellCare (S5967) Members' Rating of Plan: 81% www.wellcarepdp.com WellCare Classic (PDP) (144) Phone: 888-293-5151 WellCare Extra (PDP) (179) Phone: 888-293-5151 $31.70 $360 some drugs; call plan $55.80 $0 $0 - $47 Copay and/or $0 - $30 Copay and/or