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Cigna Healthcare Saver Rx (PDP) - S5617-353-000
Monthly Premium
Cigna Healthcare Saver 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.
Monthly Premium
New York 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 New York Medicare prescription drug plans like the one below and find a plan that offers the benefits you want at an affordable price.
Cigna Healthcare Saver Rx (PDP) - S5617-353-000 Basic Costs and Coverage
Coverage | Details |
---|---|
Monthly plan premium | $41.60 |
Annual deductible | $590.00 |
Preferred pharmacies? | Yes |
Accepts Mail Order? | Yes |
Star Rating | 2.5 out of 5 stars |
Prescription Drug Costs and Coverage
The Cigna Healthcare Saver Rx (PDP) is a prescription drug plan which offers the following coverage:
Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
---|---|---|
Preferred retail | $0.00 | $5.00 |
Standard retail | $6.00 | $13.00 |
Preferred mail order | $0.00 | $5.00 |
Standard mail order | $6.00 | $13.00 |
Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
---|---|---|
Preferred retail | $0.00 | $10.00 |
Standard retail | $12.00 | $26.00 |
Preferred mail order | $0.00 | $10.00 |
Standard mail order | $12.00 | $26.00 |
Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
---|---|---|
Preferred retail | $0.00 | $15.00 |
Standard retail | $18.00 | $39.00 |
Preferred mail order | $0.00 | $3.00 |
Standard mail order | $18.00 | $39.00 |
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 | $0.00 | $5.00 | 16% | 41% | 25% |
Standard retail | $6.00 | $13.00 | 20% | 42% | 25% |
Preferred mail order | $0.00 | $5.00 | 16% | 41% | 25% |
Standard mail order | $6.00 | $13.00 | 20% | 42% | 25% |
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 | $0.00 | $10.00 | 16% | 41% | N/A |
Standard retail | $12.00 | $26.00 | 20% | 42% | N/A |
Preferred mail order | $0.00 | $10.00 | 16% | 41% | N/A |
Standard mail order | $12.00 | $26.00 | 20% | 42% | 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 | $0.00 | $15.00 | 16% | 41% | N/A |
Standard retail | $18.00 | $39.00 | 20% | 42% | N/A |
Preferred mail order | $0.00 | $3.00 | 16% | 41% | N/A |
Standard mail order | $18.00 | $39.00 | 20% | 42% | N/A |
Plan Documents
Links to plan documents |
New York Counties Served
- Albany
- Allegany
- Bergen
- Bronx
- Broome
- Cattaraugus
- Cayuga
- Chautauqua
- Chemung
- Chenango
- Clinton
- Columbia
- Cortland
- Delaware
- Dutchess
- Erie
- Essex
- Fairfield
- Franklin
- Fulton
- Genesee
- Greene
- Hamilton
- Herkimer
- Jefferson
- Kings
- Lewis
- Livingston
- Madison
- Monroe
- Montgomery
- Nassau
- New York
- Niagara
- Oneida
- Onondaga
- Ontario
- Orange
- Orleans
- Oswego
- Otsego
- Passaic
- Putnam
- Queens
- Rensselaer
- Richmond
- Rockland
- Saint Lawrence
- Saratoga
- Schenectady
- Schoharie
- Schuyler
- Seneca
- Steuben
- Suffolk
- Sullivan
- Susquehanna
- Tioga
- Tompkins
- Ulster
- Warren
- Washington
- Wayne
- Westchester
- Wyoming
- Yates