Oklahoma by shitingting

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									  State    PDP Region Organizatio Plan Name Drug Plan    Drug           No        Offers    Type of
                       n Name               Premium  1 Deductible   Premium      Variable    Extra
                                                                    with Full   Copayment Coverage
                                                                       Low           s     Offered in
                                                                     Income       (Tiers)   the Gap
                                                                    Subsidy               (G=generics;

                                Aetna
                                Medicare
                      Aetna     Rx
Oklahoma      23      Medicare Essentials     $36.12     $250                       
                                Aetna
                      Aetna     Medicare
Oklahoma      23      Medicare Rx Plus        $46.79       $0                                 G
                                Aetna
                                Medicare
                      Aetna     Rx
Oklahoma      23      Medicare Premier        $62.76       $0                                 G
                      BLUE
                      CROSS
                      AND
                      BLUE
                      SHIELD
                      OF        Medicare
                      OKLAHO Blue Rx
Oklahoma      23      MA        Basic         $30.09     $250                      
                      BLUE
                      CROSS
                      AND
                      BLUE
                      SHIELD
                      OF        Medicare
                      OKLAHO Blue Rx
Oklahoma      23      MA        Basic Plus    $31.17       $0                      
                      BLUE
                      CROSS
                      AND
                      BLUE
                      SHIELD
                      OF        Medicare
                      OKLAHO Blue Rx
Oklahoma      23      MA        Enhanced      $36.87       $0                                 G
                                CIGNATU
                      CIGNA     RE Rx
                      HealthCar Value
Oklahoma      23      e         Plan          $35.47     $250                       
                      CIGNA     CIGNATU
                      HealthCar RE Rx
Oklahoma      23      e         Plus Plan     $40.69       $0                       
                            CIGNATU
                CIGNA       RE Rx
                HealthCar   Complete
Oklahoma   23   e           Plan        $48.75    $0           G
                Coventry
                AdvantraR   AdvantraR
Oklahoma   23   x           x Value     $22.09    $0        
                Coventry
                AdvantraR   AdvantraR
Oklahoma   23   x           x Premier   $33.33    $0        

                Coventry AdvantraR
                AdvantraR x Premier
Oklahoma   23   x         Plus          $45.56    $0        
                          Generatio
                          ns
                Generatio Healthcar
                ns        e
                Healthcar Standard
Oklahoma   23   e         PDP           $38.19   $250       
                          Generatio
                          ns
                Generatio Healthcar
                ns        e
                Healthcar Enhanced
Oklahoma   23   e         PDP           $62.46   $150       
                          Humana
                          PDP
                          Standard
                Humana S5884-
Oklahoma   23   Inc.      081           $10.07   $250   
                          Humana
                          PDP
                          Enhanced
                Humana S5884-
Oklahoma   23   Inc.      021           $16.67    $0        
                          Humana
                          PDP
                          Complete
                Humana S5884-
Oklahoma   23   Inc.      051           $57.85    $0           G/B
                          Prescripti
                Marquette on
                National Pathway
                Life      Silver
                Insurance Plan Reg
Oklahoma   23   Company 23              $43.27   $250       
                Marquette  Prescripti
                National   on
                Life       Pathway
                Insurance  Gold Plan
Oklahoma   23   Company    Reg 23       $54.04    $0        
                           Prescripti
                Marquette on
                National Pathway
                Life       Platinum
                Insurance Plan Reg
Oklahoma   23   Company 23              $70.79    $0        
                Medco
                Health
                Solutions, YOURx
Oklahoma   23   Inc.       PLAN         $33.12   $250      

                       Communit
                MEMBER y Care Rx
Oklahoma   23   HEALTH BASIC            $31.17   $250      

                           Communit
                MEMBER y Care Rx
Oklahoma   23   HEALTH CHOICE           $39.25   $250       
                           Communit
                MEMBER y Care Rx
Oklahoma   23   HEALTH GOLD             $43.22   $100       
                PacifiCare
                Life and
                Health     PacifiCare
                Insurance Saver
Oklahoma   23   Company Plan            $32.45    $0       
                PacifiCare
                Life and
                Health     PacifiCare
                Insurance Select
Oklahoma   23   Company Plan            $44.88    $0        
                PacifiCare
                Life and
                Health     PacifiCare
                Insurance Comprehe
Oklahoma   23   Company nsive Plan      $49.56    $0           G
                           Prescripti
                           on
                Pennsylva Pathway
                nia Life   Bronze
                Insurance Plan Reg
Oklahoma   23   Company 23              $33.92   $250   
                              Prescripti
                              on
                   Pennsylva Pathway
                   nia Life   Silver
                   Insurance Plan
Oklahoma     23    Company Reg23           $43.18       $250       
                              Prescripti
                   Pennsylva on
                   nia Life   Pathway
                   Insurance Gold Plan
Oklahoma     23    Company Reg 23          $53.98        $0        
                   SilverScri SilverScri
Oklahoma     23    pt         pt           $30.99       $250      
                   SilverScri SilverScri
Oklahoma     23    pt         pt Plus      $60.04       $100       
                   Sterling   Sterling
                   Prescripti Prescripti
                   on Drug    on Drug
Oklahoma     23    Plan       Plan         $53.83       $100       
                              Medicare
                              Rx
Oklahoma     23    Unicare    Rewards      $24.81       $250      
                              Medicare
                              Rx
                              Rewards
Oklahoma     23    Unicare    Plus         $32.50        $0        
                              Medicare
                              Rx
                              Rewards
Oklahoma     23    Unicare    Premier      $43.54        $0           G
                              UA
                              Medicare
                   United     Part D
                   American Prescripti
                   Insurance on Drug
Oklahoma     23    Company Cov             $38.08        $0        
                   United     AARP
                   Healthcar Medicare
Oklahoma     23    e          Rx Plan      $28.79        $0       
                              United
                   United     Medicare
                   Healthcar MedAdva
Oklahoma     23    e          nce          $32.16        $0       
                              WellCare
Oklahoma     23    WellCare Signature      $28.86        $0       
                              WellCare
Oklahoma     23    WellCare Complete       $47.25        $0        
                              WellCare
Oklahoma     23    WellCare Premier        $50.98        $0        
Sources: CMS PDP Landscape of Local Plans Source File
Number of Number of Number of Mail Order      contract #     plan #   segement # formulary benefit_type
 Top 100     Top 100     Top 100    Offered
 Drugs on     Drugs     Drugs with
Formulary 2 Requiring      Cost
              Prior      Sharing
            Authorizati below $20 2




   86          5          54                 S5810        057                0       2662 Actuarially Equivalent Standard


   86          5          54                 S5810        159                0       2662 Enhanced Alternative



   100        38          78                 S5810        193                0       2681 Enhanced Alternative




   100        13          92                 S5566        001                0       3432 Actuarially Equivalent Standard




   100        13          58                 S5566        002                0       3432 Basic Alternative




   100        13          58                 S5566        003                0       3432 Enhanced Alternative



   99         31          86                 S5617        113                0       1241 Actuarially Equivalent Standard


   99         31          57                 S5617        115                0       1241 Enhanced Alternative
99    31   57       S5617   193   0   1241 Enhanced Alternative


78    9    57       S5670   123   0   2764 Enhanced Alternative


100   12   57       S5670   124   0   2759 Enhanced Alternative



100   12   N/A      S5670   126   0   2766 Basic Alternative




88    12   57       S5704   001   0   3376 Actuarially Equivalent Standard




88    12   57       S5704   002   0   3376 Enhanced Alternative




99    8    N/A      S5884   081   0   1863 Defined Standard Benefit




99    8    56       S5884   021   0   1863 Enhanced Alternative




99    8    56       S5884   051   0   1863 Enhanced Alternative




92    1    57       S5581   134   0   1446 Actuarially Equivalent Standard
92    1    57       S5581   038   0   1446 Enhanced Alternative




100   0    57       S5581   062   0   1494 Enhanced Alternative



98    10   95       S5660   023   0   3164 Basic Alternative



95    10   58        S5803   092   0   3422 Actuarially Equivalent Standard



95    10   91        S5803   160   0   3422 Actuarially Equivalent Standard


95    10   58        S5803   126   0   3422 Enhanced Alternative




78    9    53       S5921   202   0   2654 Basic Alternative




87    3    54       S5921   201   0   2656 Basic Alternative




78    9    53       S5921   235   0   2654 Enhanced Alternative




92    1    N/A      S5597   088   0   1446 Defined Standard Benefit
92    1    57      S5597   187   0   1446 Actuarially Equivalent Standard




92    1    57      S5597   055   0   1446 Enhanced Alternative

92    5    92      S5601   046   0    897 Actuarially Equivalent Standard

98    5    56      S5601   047   0    619 Basic Alternative



98    5    56      S4802   014   0   3245 Basic Alternative


92    5    56      S5960   023   0   2493 Actuarially Equivalent Standard



92    5    56      S5960   059   0   2493 Enhanced Alternative



98    5    57      S5960   093   0   2546 Enhanced Alternative




99    10   58      S5755   026   0   3296 Basic Alternative


100   2    58      S5820   022   0   3440 Basic Alternative



100   2    58      S5820   126   0   3440 Basic Alternative

88    12   56      S5967   057   0   2366 Basic Alternative

85    9    74      S5967   092   0   2003 Enhanced Alternative

85    9    56      S5967   126   0   2629 Enhanced Alternative
icl_amount   STCD




     2250 OK


     2250 OK



     2250 OK




     2250 OK




     2250 OK




     2250 OK



     2250 OK


     2250 OK
2250 OK


2250 OK


2250 OK



2250 OK




2250 OK




3000 OK




2250 OK




2250 OK




  0 OK




2250 OK
2000 OK




2000 OK



2250 OK



2250 OK



2250 OK


2250 OK




2250 OK




2250 OK




2250 OK




2250 OK
2250 OK




2000 OK

2250 OK

2250 OK



2250 OK


2250 OK



2250 OK



2250 OK




2250 OK


2250 OK



2250 OK

2250 OK

1850 OK

2250 OK

								
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