Tennessee

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posted:: 9/30/2012
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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
Tennesse              Aetna        Rx
e             12      Medicare     Essentials   $38.86   $250                       
                                   Aetna
Tennesse              Aetna        Medicare
e             12      Medicare     Rx Plus      $50.45     $0                                 G
                                   Aetna
                                   Medicare
Tennesse              Aetna        Rx
e             12      Medicare     Premier      $66.75     $0                                 G
                                   AmeriHeal
                      AmeriHeal    th
                      th           Advantag
Tennesse              Advantag     e Rx
e             12      e            Option l     $25.68   $250          
                                   CIGNATU
                      CIGNA        RE Rx
Tennesse              HealthCar    Value
e             12      e            Plan         $37.27   $250                       
                      CIGNA        CIGNATU
Tennesse              HealthCar    RE Rx
e             12      e            Plus Plan    $42.38     $0                       
                                   CIGNATU
                      CIGNA        RE Rx
Tennesse              HealthCar    Complete
e             12      e            Plan         $51.03     $0                                 G
                      Coventry
Tennesse              AdvantraR    AdvantraR
e             12      x            x Value      $22.86     $0                       
                      Coventry
Tennesse              AdvantraR    AdvantraR
e             12      x            x Premier    $33.99     $0                       

                      Coventry     AdvantraR
Tennesse              AdvantraR    x Premier
e             12      x            Plus         $43.85     $0                       
                      First        First
Tennesse              Health       Health
e             12      Premier      Premier      $21.80   $250          
                      HealthSpri   HealthSpri
                      ng           ng
                      Prescripti   Prescripti
Tennesse              on Drug      on Drug
e             12      Plan         Plan         $25.54   $250          
                          Humana
                          PDP
                          Standard
Tennesse        Humana S5884-
e          12   Inc.      070           $14.08   $250   
                          Humana
                          PDP
                          Enhanced
Tennesse        Humana S5884-
e          12   Inc.      001           $22.48    $0        
                          Humana
                          PDP
                          Complete
Tennesse        Humana S5884-
e          12   Inc.      040           $67.16    $0           G/B
                          Prescripti
                Marquette on
                National Pathway
                Life      Silver
Tennesse        Insurance Plan Reg
e          12   Company 12              $42.41   $250       

                Marquette  Prescripti
                National   on
                Life       Pathway
Tennesse        Insurance  Gold Plan
e          12   Company    Reg 12       $53.31    $0        
                           Prescripti
                Marquette on
                National Pathway
                Life       Platinum
Tennesse        Insurance Plan Reg
e          12   Company 12              $69.98    $0        
                Medco
                Health
Tennesse        Solutions, YOURx
e          12   Inc.       PLAN         $30.11   $250      

                       Communit
Tennesse        MEMBER y Care Rx
e          12   HEALTH BASIC            $33.31   $250       

                       Communit
Tennesse        MEMBER y Care Rx
e          12   HEALTH CHOICE           $41.41   $250       
                       Communit
Tennesse        MEMBER y Care Rx
e          12   HEALTH GOLD             $45.23   $100       
                PacifiCare
                Life and
                Health       PacifiCare
Tennesse        Insurance    Saver
e          12   Company      Plan         $34.88    $0        
                PacifiCare
                Life and
                Health       PacifiCare
Tennesse        Insurance    Select
e          12   Company      Plan         $47.47    $0        
                PacifiCare
                Life and
                Health       PacifiCare
Tennesse        Insurance    Comprehe
e          12   Company      nsive Plan   $53.70    $0           G
                             Prescripti
                             on
                Pennsylva    Pathway
                nia Life     Bronze
Tennesse        Insurance    Plan Reg
e          12   Company      12           $33.07   $250
                             Prescripti
                             on
                Pennsylva    Pathway
                nia Life     Silver
Tennesse        Insurance    Plan
e          12   Company      Reg12        $42.32   $250       
                             Prescripti
                Pennsylva    on
                nia Life     Pathway
Tennesse        Insurance    Gold Plan
e          12   Company      Reg 12       $53.25    $0        
                             Advantag
                             e
Tennesse        RxAmeric     Allegiance
e          12   a            Plan         $34.92   $250
                             Advantag
                             e
Tennesse        RxAmeric     Freedom
e          12   a            Plan         $36.04   $250
Tennesse        SilverScri   SilverScri
e          12   pt           pt           $32.34   $250       
Tennesse        SilverScri   SilverScri
e          12   pt           pt Plus      $61.25   $100       
                             Medicare
Tennesse                     Rx
e          12   Unicare      Rewards      $29.65   $250      
                             Medicare
                             Rx
Tennesse                     Rewards
e          12   Unicare      Plus         $37.34    $0        
                              Medicare
                              Rx
Tennesse                      Rewards
e            12    Unicare    Premier      $49.77       $0          G
                              UA
                              Medicare
                   United     Part D
                   American Prescripti
Tennesse           Insurance on Drug
e            12    Company Cov             $36.88       $0       
                   United     AARP
Tennesse           Healthcar Medicare
e            12    e          Rx Plan      $27.28       $0      
                              United
                   United     Medicare
Tennesse           Healthcar MedAdva
e            12    e          nce          $31.54       $0      
Tennesse                      WellCare
e            12    WellCare Signature      $26.46       $0      
Tennesse                      WellCare
e            12    WellCare Complete       $45.10       $0       
Tennesse                      WellCare
e            12    WellCare Premier        $48.95       $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        046                0       2662 Actuarially Equivalent Standard


   86          5          54                 S5810        148                0       2662 Enhanced Alternative



   100        38          78                 S5810        182                0       2681 Enhanced Alternative




   92         13         N/A                  S5783        005                0       3416 Defined Standard Benefit



   99         31          86                 S5617        058                0       1241 Actuarially Equivalent Standard


   99         31          57                 S5617        060                0       1241 Enhanced Alternative



   99         31          57                 S5617        182                0       1241 Enhanced Alternative


   78          9          57                 S5670        063                0       2764 Enhanced Alternative


   100        12          77                 S5670        064                0       2759 Enhanced Alternative



   100        12          22                 S5670        066                0       2766 Basic Alternative


   100        12         N/A                  S5768        015                0       1727 Defined Standard Benefit




   89         22         N/A                 S5932        001                0       3122 Defined Standard Benefit
99    8    N/A      S5884   070   0   1863 Defined Standard Benefit




99    8    56       S5884   001   0   1863 Enhanced Alternative




99    8    56       S5884   040   0   1863 Enhanced Alternative




92    1    57       S5581   125   0   1446 Actuarially Equivalent Standard




92    1    57       S5581   029   0   1446 Enhanced Alternative




100   0    57       S5581   053   0   1494 Enhanced Alternative



98    10   95       S5660   012   0   3164 Basic Alternative



95    10   58        S5803   081   0   3422 Actuarially Equivalent Standard



95    10   91        S5803   149   0   3422 Actuarially Equivalent Standard


95    10   58        S5803   115   0   3422 Enhanced Alternative
78    9    53       S5921   152   0   2654 Basic Alternative




87    3    54       S5921   151   0   2656 Basic Alternative




78    9    53       S5921   153   0   2654 Enhanced Alternative




92    1    N/A      S5597   077   0   1446 Defined Standard Benefit




92    1    57       S5597   176   0   1446 Actuarially Equivalent Standard




92    1    57       S5597   044   0   1446 Enhanced Alternative



88    12   N/A      S5644   012   0   1479 Defined Standard Benefit



100   12   N/A      S5644   056   0   1644 Defined Standard Benefit

92    5    92       S5601   024   0    897 Actuarially Equivalent Standard

98    5    56       S5601   025   0    619 Basic Alternative


92    5    56       S5960   012   0   2493 Actuarially Equivalent Standard



92    5    56       S5960   048   0   2493 Enhanced Alternative
98    5    57      S5960   082   0   2546 Enhanced Alternative




99    10   58      S5755   015   0   3296 Basic Alternative


100   2    58      S5820   011   0   3440 Basic Alternative



100   2    58      S5820   115   0   3440 Basic Alternative

88    12   56      S5967   046   0   2366 Basic Alternative

85    9    74      S5967   080   0   2003 Enhanced Alternative

85    9    56      S5967   115   0   2629 Enhanced Alternative
icl_amount   STCD




     2250 TN


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2000 TN




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1850 TN

2250 TN