2020 Cigna-HealthSpring Rx Secure (PDP) S5617-215-000 in PA from Cigna | HealthPocket

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County

Insurance Type	Medicare Advantage Prescription Drug Plan (Part D)
Insurance Provider	Cigna
Plan ID	S5617-215-000
Plan Year	2020
CMS Rating	Not Rated
Plan Type	PDP
Annual Deductible	$435.00
Out-of-Pocket Maximum	N/A

What To Know About This Plan	This is a drug coverage only plan This plan is available for 2021. see plan

Why We Like This Plan	has a copay of $1 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Overview

Premium
Total monthly premium	$33.40
Deductible
Drug plan deductible	$435.00

Drug coverage & costs

Part B drugs
Chemotherapy drugs	Not covered
Other Part B drugs	Not covered

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day Supply	Preferred Retail Pharmacies Drug Cost	Standard Retail Pharmacies Drug Cost	Preferred Mail-Order Drug Cost	Standard Mail-Order Drug Cost
Tier 1: Preferred Generic	$1 copay	$6 copay	$1 copay	$6 copay
Tier 2: Generic	$2 copay	$7 copay	$2 copay	$7 copay
Tier 3: Preferred Brand	$30 copay	$32 copay	$30 copay	$32 copay
Tier 4: Non-Preferred Drug	38% coinsurance	38% coinsurance	38% coinsurance	38% coinsurance
Tier 5: Specialty Tier	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance
Tier 6: Select Care Drugs	$0 copay	$5 copay	$0 copay	$5 copay

60 Day Supply	Preferred Retail Pharmacies Drug Cost	Standard Retail Pharmacies Drug Cost	Preferred Mail-Order Drug Cost	Standard Mail-Order Drug Cost
Tier 1: Preferred Generic	$2 copay	$12 copay	$2 copay	$12 copay
Tier 2: Generic	$4 copay	$14 copay	$4 copay	$14 copay
Tier 3: Preferred Brand	$60 copay	$64 copay	$60 copay	$64 copay
Tier 4: Non-Preferred Drug	38% coinsurance	38% coinsurance	38% coinsurance	38% coinsurance
Tier 5: Specialty Tier
Tier 6: Select Care Drugs	$0 copay	$10 copay	$0 copay	$10 copay

90 Day Supply	Preferred Retail Pharmacies Drug Cost	Standard Retail Pharmacies Drug Cost	Preferred Mail-Order Drug Cost	Standard Mail-Order Drug Cost
Tier 1: Preferred Generic	$3 copay	$18 copay	$0 copay	$18 copay
Tier 2: Generic	$6 copay	$21 copay	$6 copay	$21 copay
Tier 3: Preferred Brand	$90 copay	$96 copay	$90 copay	$96 copay
Tier 4: Non-Preferred Drug	38% coinsurance	38% coinsurance	38% coinsurance	38% coinsurance
Tier 5: Specialty Tier
Tier 6: Select Care Drugs	$0 copay	$15 copay	$0 copay	$15 copay

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs	Not Rated
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate
Statin Use in Persons with Diabetes	Not Rated

Pharmacies that accept Cigna-HealthSpring Rx Secure (PDP) Prescription Drug Plan for Pennsylvania

Pharmacy Name

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Erickson Advantage Liberty without Drugs (HMO)
COST:from $0	CMS Rating:

Humana Honor (PPO)
COST:from $0	CMS Rating:

Aetna Medicare Advantra Credit Value (PPO)
COST:from $0	CMS Rating:

Vibra Health Plan Essential (PPO)
COST:from $0	CMS Rating:

Lasso Healthcare (MSA)
COST:from $0	CMS Rating:Not Rated

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.