Asuris Medicare Script Enhanced (PDP)
Health Insurance Company: Asuris Northwest Health
Medicare Prescription Drug Part D Plan Details
$127 /mo
monthly premium
Asuris Medicare Script Enhanced (PDP)
Coverage
Overall Star Rating (2024)
- Rx
General Plan Details
Prescription Drug Deductible
$0
Preferred Generic copay
$3
Preferred Brand copay
$47
Eligible for Low Income Subsidy
No
Rx Drug Coverage - Standard Retail Cost
Tier 1: Preferred Generic
$3.00 copay (30-day supply)
$6.00 copay (90-day supply)
Tier 2: Generic
$10.00 copay (30-day supply)
$20.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$117.50 copay (90-day supply)
Tier 4: Non-Preferred Drug
40% coinsurance (30-day supply)
40% coinsurance (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
Rx Drug Coverage - Standard Mail Order Cost
Tier 1: Preferred Generic
$3.00 copay (30-day supply)
$6.00 copay (90-day supply)
Tier 2: Generic
$10.00 copay (30-day supply)
$20.00 copay (90-day supply)
Tier 3: Preferred Brand
$47.00 copay (30-day supply)
$117.50 copay (90-day supply)
Tier 4: Non-Preferred Drug
40% coinsurance (30-day supply)
40% coinsurance (90-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
Plan Links
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Where This Plan is Available
State:
Counties:
Adams, Asotin, Benton, Chelan, Clallam, Clark, Columbia, Cowlitz, Douglas, Ferry, Franklin, Garfield, Grant, Grays Harbor, Island, Jefferson, King, Kitsap, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Oreille, Pierce, San Juan, Skagit, Skamania, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Whitman, Yakima
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Additional Plan Info
Year:
2024
Plan ID:
S5609-002-0
Insurance Company Website:
Asuris Northwest Health