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Cigna Healthcare Saver Rx (PDP) - S5617-369-000
$4.50
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.
$4.50
Monthly Premium
Arkansas 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 Arkansas 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) - S5617-369-000 Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $4.50 |
| 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 | $20.00 |
| Preferred mail order | $0.00 | $5.00 |
| Standard mail order | $8.00 | $20.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $10.00 |
| Standard retail | $16.00 | $40.00 |
| Preferred mail order | $0.00 | $10.00 |
| Standard mail order | $16.00 | $40.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $15.00 |
| Standard retail | $24.00 | $60.00 |
| Preferred mail order | $0.00 | $3.00 |
| Standard mail order | $24.00 | $60.00 |
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 | $20.00 | 22% | 50% | 25% |
| Preferred mail order | $0.00 | $5.00 | 17% | 50% | 25% |
| Standard mail order | $8.00 | $20.00 | 22% | 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 | $40.00 | 22% | 50% | N/A |
| Preferred mail order | $0.00 | $10.00 | 17% | 50% | N/A |
| Standard mail order | $16.00 | $40.00 | 22% | 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 | $60.00 | 22% | 50% | N/A |
| Preferred mail order | $0.00 | $3.00 | 17% | 50% | N/A |
| Standard mail order | $24.00 | $60.00 | 22% | 50% | N/A |
Plan Documents
| Links to plan documents |
Arkansas Counties Served
- Arkansas
- Ashley
- Baxter
- Benton
- Boone
- Bradley
- Calhoun
- Carroll
- Chicot
- Clark
- Clay
- Cleburne
- Cleveland
- Columbia
- Conway
- Craighead
- Crawford
- Crittenden
- Cross
- Dallas
- Desha
- Drew
- Faulkner
- Franklin
- Fulton
- Garland
- Grant
- Greene
- Hempstead
- Hot Spring
- Howard
- Independence
- Izard
- Jackson
- Jefferson
- Johnson
- Lafayette
- Lawrence
- Le Flore
- Lee
- Lincoln
- Little River
- Logan
- Lonoke
- Madison
- Marion
- Mccurtain
- Miller
- Mississippi
- Monroe
- Montgomery
- Nevada
- Newton
- Ouachita
- Perry
- Phillips
- Pike
- Poinsett
- Polk
- Pope
- Prairie
- Pulaski
- Randolph
- Saint Francis
- Saline
- Scott
- Searcy
- Sebastian
- Sevier
- Sharp
- Stone
- Union
- Van Buren
- Washington
- White
- Woodruff
- Yell