Cigna Healthcare Extra Rx (PDP)
Health Insurance Company: Cigna Healthcare
Medicare Prescription Drug Part D Plan Details
- Rx
General Plan Details
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
$9.00 copay (30-day supply)
$27.00 copay (90-day supply)
Tier 3: Preferred Brand
20% coinsurance (30-day supply)
20% 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
$12.00 copay (30-day supply)
$36.00 copay (90-day supply)
Tier 2: Generic
$20.00 copay (30-day supply)
$60.00 copay (90-day supply)
Tier 3: Preferred Brand
23% coinsurance (30-day supply)
23% 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
$12.00 copay (30-day supply)
$36.00 copay (90-day supply)
Tier 2: Generic
$20.00 copay (30-day supply)
$60.00 copay (90-day supply)
Tier 3: Preferred Brand
23% coinsurance (30-day supply)
23% 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
$9.00 copay (30-day supply)
$6.00 copay (90-day supply)
Tier 3: Preferred Brand
20% coinsurance (30-day supply)
20% 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
Ready to Enroll Online?
Or call and get free advice from licensed insurance agents
Looking for other plans in your area?