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Cigna Healthcare Saver Rx (PDP) - S5617-365-000
$28.20
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.
$28.20
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 Saver Rx (PDP) - S5617-365-000 Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $28.20 |
| 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:
Deductible Coverage Level
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $5.00 |
| Standard retail | $8.00 | $17.00 |
| Preferred mail order | $0.00 | $5.00 |
| Standard mail order | $8.00 | $17.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $10.00 |
| Standard retail | $16.00 | $34.00 |
| Preferred mail order | $0.00 | $10.00 |
| Standard mail order | $16.00 | $34.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $15.00 |
| Standard retail | $24.00 | $51.00 |
| Preferred mail order | $0.00 | $3.00 |
| Standard mail order | $24.00 | $51.00 |
Initial Coverage Level
| 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 | 17% | 50% | 25% |
| Standard retail | $8.00 | $17.00 | 21% | 50% | 25% |
| Preferred mail order | $0.00 | $5.00 | 17% | 50% | 25% |
| Standard mail order | $8.00 | $17.00 | 21% | 50% | 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 | 17% | 50% | N/A |
| Standard retail | $16.00 | $34.00 | 21% | 50% | N/A |
| Preferred mail order | $0.00 | $10.00 | 17% | 50% | N/A |
| Standard mail order | $16.00 | $34.00 | 21% | 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 | $0.00 | $15.00 | 17% | 50% | N/A |
| Standard retail | $24.00 | $51.00 | 21% | 50% | N/A |
| Preferred mail order | $0.00 | $3.00 | 17% | 50% | N/A |
| Standard mail order | $24.00 | $51.00 | 21% | 50% | N/A |
Plan Documents
| Links to plan documents |
Kentucky Counties Served
- Adair
- Allen
- Anderson
- Ballard
- Barren
- Bath
- Bell
- Boone
- Bourbon
- Boyd
- Boyle
- Bracken
- Breathitt
- Breckinridge
- Bullitt
- Butler
- Caldwell
- Calloway
- Campbell
- Carlisle
- Carroll
- Carter
- Casey
- Christian
- Claiborne
- Clark
- Clay
- Clinton
- Crittenden
- Cumberland
- Daviess
- Edmonson
- Elliott
- Estill
- Fayette
- Fleming
- Floyd
- Franklin
- Fulton
- Gallatin
- Garrard
- Grant
- Graves
- Grayson
- Green
- Greenup
- Hancock
- Hardin
- Harlan
- Harrison
- Hart
- Henderson
- Henry
- Hickman
- Hopkins
- Jackson
- Jefferson
- Jessamine
- Johnson
- Kenton
- Knott
- Knox
- Larue
- Laurel
- Lawrence
- Lee
- Leslie
- Letcher
- Lewis
- Lincoln
- Livingston
- Logan
- Lyon
- Madison
- Magoffin
- Marion
- Marshall
- Martin
- Mason
- Mccracken
- Mccreary
- Mclean
- Meade
- Menifee
- Mercer
- Metcalfe
- Monroe
- Montgomery
- Morgan
- Muhlenberg
- Nelson
- Nicholas
- Ohio
- Oldham
- Owen
- Owsley
- Pendleton
- Perry
- Pickett
- Pike
- Powell
- Pulaski
- Robertson
- Rockcastle
- Rowan
- Russell
- Scott
- Shelby
- Simpson
- Spencer
- Taylor
- Todd
- Trigg
- Trimble
- Union
- Warren
- Washington
- Wayne
- Webster
- Whitley
- Wolfe
- Woodford
Indiana Counties Served
- Adams
- Allen
- Bartholomew
- Benton
- Blackford
- Boone
- Brown
- Carroll
- Cass
- Clark
- Clay
- Clinton
- Crawford
- Daviess
- Dearborn
- Decatur
- Dekalb
- Delaware
- Dubois
- Elkhart
- Fayette
- Floyd
- Fountain
- Franklin
- Fulton
- Gibson
- Grant
- Greene
- Hamilton
- Hancock
- Harrison
- Hendricks
- Henry
- Howard
- Huntington
- Jackson
- Jasper
- Jay
- Jefferson
- Jennings
- Johnson
- Knox
- Kosciusko
- La Porte
- Lagrange
- Lake
- Lawrence
- Madison
- Marion
- Marshall
- Martin
- Miami
- Monroe
- Montgomery
- Morgan
- Newton
- Noble
- Ohio
- Orange
- Owen
- Parke
- Perry
- Pike
- Porter
- Posey
- Pulaski
- Putnam
- Randolph
- Ripley
- Rush
- Scott
- Shelby
- Spencer
- St Joseph
- Starke
- Steuben
- Sullivan
- Switzerland
- Tippecanoe
- Tipton
- Union
- Vanderburgh
- Vermillion
- Vigo
- Wabash
- Warren
- Warrick
- Washington
- Wayne
- Wells
- White
- Whitley