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Cigna Healthcare Extra Rx (PDP)

Health Insurance Company: Cigna Healthcare

Medicare Prescription Drug Part D Plan Details

Cigna Healthcare
$128 /mo
monthly premium
Cigna Healthcare Extra Rx (PDP)
Coverage
Overall Star Rating (2025)
  • Rx
2.5
out of 5 stars

General Plan Details

Prescription Drug Deductible
$175
Preferred Generic copay
$10
Preferred Brand copay
$0
Eligible for Low Income Subsidy
No

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

$1.00 copay (30-day supply)
$3.00 copay (90-day supply)

Tier 2: Generic

$8.00 copay (30-day supply)
$24.00 copay (90-day supply)

Tier 3: Preferred Brand

19% coinsurance (30-day supply)
19% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

31% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 2: Generic

$19.00 copay (30-day supply)
$57.00 copay (90-day supply)

Tier 3: Preferred Brand

22% coinsurance (30-day supply)
22% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

31% coinsurance (30-day supply)

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 2: Generic

$19.00 copay (30-day supply)
$57.00 copay (90-day supply)

Tier 3: Preferred Brand

22% coinsurance (30-day supply)
22% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

31% coinsurance (30-day supply)

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

$1.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$8.00 copay (30-day supply)
$5.00 copay (90-day supply)

Tier 3: Preferred Brand

19% coinsurance (30-day supply)
19% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

31% coinsurance (30-day supply)

Plan Links

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Where This Plan is Available

Additional Plan Info

Plan Year:
2025
Insurance Company Website:
Cigna Healthcare

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

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