Prescription Drug Plan

Plan Information

• Premiums, Deductibles and Copays vary by state.
  • This plan’s deductible is waived for Tier 1 and Tier 2 Prescriptions. Applies to Tier 3-5 medications.

Please reference your personal Rx Report provided by HTA which shows the plan premium, copays by tier ranking, specific costs and drug limits or restrictions for your current medication list.

Pharmacies

• Mail Order Pharmacy Information (click highlighted link to see details).
  • $0 copay on Tier 1, 90 day Mail Order Prescriptions
• Preferred Pharmacy Search: 
  • You are not required to use Walmart Pharmacy although Walmart is the preferred pharmacy and can receive lower copays on many RX’s

Plan Documents

• Summary of Benefits
• Formulary Rx List
• Carrier Star Rating

All Medicare Prescription Drug Plans have 4 Stages of Coverage.

Please click on the link for more details and a short video overview on Medicare Prescription Drug Plans and Stages.