| 2012 New York State Stand Alone Prescription Drug Plans | ||||||||
|---|---|---|---|---|---|---|---|---|
| Company Name | 2012 Plan Name | Benefit Type | $0 Premium Full LIS? | Monthly Drug Premium | Annual Drug Deductible | Type of Add'l Drug Coverage in Gap | Contract ID | Plan ID |
| Aetna Medicare | Aetna CVS/pharm Presc. Drug Plan (PDP) | Basic | Yes | $26.00 | $320 | No Gap Coverage | S5810 | 037 |
| Aetna Medicare | Aetna Medicare Rx Premier (PDP) | Enhanced | No | $95.20 | $0 | Many Generics | S5810 | 239 |
| Bravo Health | BravoRx (PDP) | Basic | Yes | $40.80 | $320 | No Gap Coverage | S5998 | 001 |
| CIGNA Medicare Rx | CIGNA Medicare Rx Plan One (PDP) | Basic | Yes | $34.10 | $320 | No Gap Coverage | S5617 | 013 |
| Community CCRx PDP | Community CCRx Choice (PDP) | Enhanced | No | $79.00 | $0 | No Gap Coverage | S5825 | 017 |
| Community CCRx PDP | Community CCRx Basic (PDP) | Basic | Yes | $37.10 | $320 | No Gap Coverage | S5825 | 045 |
| EmblemHealth Medicare PDP | Medicare Prescription Drug Plan (PDP) | Basic | No | $44.50 | $320 | No Gap Coverage | S5966 | 001 |
| EnvisionRx Plus | EnvisionRxPlus Silver (PDP) | Basic | Yes | $36.60 | $320 | No Gap Coverage | S7694 | 003 |
| EnvisionRx Plus | Rite Aid EnvisionRxPlus (PDP) | Enhanced | No | $65.50 | $0 | Some Generics | S7694 | 074 |
| First Health Part D | First Health Part D Premier Plus (PDP) | Enhanced | No | $99.00 | $0 | Some Generics and Some Brands | S0197 | 005 |
| First Health Part D | First Health Part D Premier (PDP) | Basic | No | $46.80 | $250 | No Gap Coverage | S5569 | 003 |
| First Health Part D | First Health Part D Value Plus (PDP) | Enhanced | No | $30.10 | $0 | No Gap Coverage | S5569 | 006 |
| First United American Life Ins. Co. | First United American - Preferred (PDP) | Enhanced | No | $51.50 | $140 | No Gap Coverage | S5580 | 003 |
| First United American Life Ins. Co. | First United American - Select (PDP) | Basic | Yes | $37.40 | $320 | No Gap Coverage | S5580 | 006 |
| HealthSpring Prescription Drug Plan | HealthSpring Presc Drug Plan -Reg 3 (PDP) | Basic | Yes | $39.90 | $320 | No Gap Coverage | S5932 | 004 |
| Humana Insurance Company of NY | Humana Complete (PDP) | Enhanced | No | $107.90 | $0 | Many Generics and Some Brands | S5552 | 002 |
| Humana Insurance Company of NY | Humana Enhanced (PDP) | Enhanced | No | $44.50 | $0 | No Gap Coverage | S5552 | 003 |
| Humana Insurance Company of NY | Humana Walmart-Preferred Rx Plan (PDP) | Basic | Yes | $15.10 | $320 | No Gap Coverage | S5552 | 004 |
| Medco Medicare Prescription Plan | Medco Medicare Presc. Plan - Value (PDP) | Basic | Yes | $36.80 | $320 | No Gap Coverage | S5983 | 004 |
| SilverScript Insurance Company | CVS Caremark Value (PDP) | Basic | Yes | $35.90 | $320 | No Gap Coverage | S5601 | 006 |
| SilverScript Insurance Company | CVS Caremark Plus (PDP) | Enhanced | No | $70.20 | $0 | No Gap Coverage | S5601 | 007 |
| Simply Prescriptions | Rx 1 (PDP) | Basic | No | $50.20 | $320 | No Gap Coverage | S3521 | 001 |
| Simply Prescriptions | Rx 3 (PDP) | Enhanced | No | $109.70 | $300 | Many Generics | S3521 | 003 |
| UniCare | MedicareRx Rewards Standard (PDP) | Basic | No | $44.70 | $320 | No Gap Coverage | S5960 | 109 |
| UniCare | MedicareRx Rewards Plus (PDP) | Enhanced | No | $94.20 | $0 | Some Generics | S5960 | 141 |
| UnitedHealthcare | AARP MedicareRx Preferred (PDP) | Basic | Yes | $40.30 | $0 | No Gap Coverage | S5805 | 001 |
| UnitedHealthcare | AARP MedicareRx Enhanced (PDP) | Enhanced | No | $89.70 | $0 | Some Generics | S5921 | 213 |
| WellCare | WellCare Signature (PDP) | Enhanced | No | $65.90 | $0 | No Gap Coverage | S5967 | 037 |
| WellCare | WellCare Classic (PDP) | Basic | Yes | $39.40 | $0 | No Gap Coverage | S5967 | 140 |
