Cigna Healthcare Extra Rx (PDP) - S5617-260-000

2.5 out of 5 stars* for plan year 2025

$111.20

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.

$111.20

Monthly Premium

Kentucky and Indiana 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 Kentucky and Indiana 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) - S5617-260-000 Basic Costs and Coverage

Coverage	Details
Monthly plan premium	$111.20
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

30 day supply
60 day supply
90 day supply

Tiers	Tier 1 Preferred Generic Drug	Tier 2 Generic Drug
Preferred retail	$1.00	$9.00
Standard retail	$12.00	$20.00
Preferred mail order	$1.00	$9.00
Standard mail order	$12.00	$20.00

Tiers	Tier 1 Preferred Generic Drug	Tier 2 Generic Drug
Preferred retail	$2.00	$18.00
Standard retail	$24.00	$40.00
Preferred mail order	$2.00	$18.00
Standard mail order	$24.00	$40.00

Tiers	Tier 1 Preferred Generic Drug	Tier 2 Generic Drug
Preferred retail	$3.00	$27.00
Standard retail	$36.00	$60.00
Preferred mail order	$0.00	$6.00
Standard mail order	$36.00	$60.00

Initial Coverage Level

30 day supply
60 day supply
90 day supply

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	$9.00	18%	50%	31%
Standard retail	$12.00	$20.00	23%	50%	31%
Preferred mail order	$1.00	$9.00	18%	50%	31%
Standard mail order	$12.00	$20.00	23%	50%	31%

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	$2.00	$18.00	18%	50%	N/A
Standard retail	$24.00	$40.00	23%	50%	N/A
Preferred mail order	$2.00	$18.00	18%	50%	N/A
Standard mail order	$24.00	$40.00	23%	50%	N/A

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	$3.00	$27.00	18%	50%	N/A
Standard retail	$36.00	$60.00	23%	50%	N/A
Preferred mail order	$0.00	$6.00	18%	50%	N/A
Standard mail order	$36.00	$60.00	23%	50%	N/A

Eligibility & Enrollment

Costs & Coverage

News & Resources

Cigna Healthcare Extra Rx (PDP) - S5617-260-000

Compare drug plans today.

Cigna Healthcare Extra Rx (PDP) - S5617-260-000 Basic Costs and Coverage

Prescription Drug Costs and Coverage

Plan Documents

Kentucky Counties Served

Indiana Counties Served