Regence Medicare Script Enhanced (PDP)
Health Insurance Company: Regence BlueShield of Idaho and Regence BC BS Utah
Medicare Prescription Drug Part D Plan Details
- Rx
General Plan Details
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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