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Cigna Healthcare Extra Rx (PDP) - S5617-246-000
$128.20
Monthly Premium
Cigna Healthcare Extra Rx (PDP) is a Medicare Part D Prescription Drug Plan offered by Cigna
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$128.20
Monthly Premium
New Hampshire and Maine Medicare beneficiaries may want to consider reviewing their Medicare prescription drug coverage options, such as a standalone Part D prescription drug plan (PDP) or a Medicare Advantage (Medicare Part C) plan that includes drug coverage.
A Part D plan can be used alongside your Original Medicare (Part A and Part B) coverage. A Medicare Advantage plan that includes drug coverage combines your Part A, Part B and Part D benefits into a single plan
Learn more about New Hampshire and Maine Medicare prescription drug plans like the one below and find a plan that offers the benefits you want at an affordable price.
Cigna Healthcare Extra Rx (PDP) - S5617-246-000 Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $128.20 |
| Annual deductible | $175.00 |
| Preferred pharmacies? | Yes |
| Accepts Mail Order? | Yes |
| Star Rating | 2.5 out of 5 stars |
Prescription Drug Costs and Coverage
The Cigna Healthcare Extra Rx (PDP) is a prescription drug plan which offers the following coverage:
Deductible Coverage Level
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $1.00 | $8.00 |
| Standard retail | $10.00 | $19.00 |
| Preferred mail order | $1.00 | $8.00 |
| Standard mail order | $10.00 | $19.00 |
Initial Coverage Level
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug | Tier 3 Preferred Brand Drug | Tier 4 Non-Preferred Drug | Tier 5 Specialty Tier Drug |
|---|---|---|---|---|---|
| Preferred retail | $1.00 | $8.00 | 19% | 50% | 31% |
| Standard retail | $10.00 | $19.00 | 22% | 50% | 31% |
| Preferred mail order | $1.00 | $8.00 | 19% | 50% | 31% |
| Standard mail order | $10.00 | $19.00 | 22% | 50% | 31% |
Plan Documents
| Links to plan documents |