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Cigna Healthcare Saver Rx (PDP) - S5617-373-000
$15.40
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.
$15.40
Monthly Premium
Oklahoma 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 Oklahoma 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) - S5617-373-000 Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $15.40 |
| 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 | 20% | 50% | 25% |
| Preferred mail order | $0.00 | $5.00 | 17% | 50% | 25% |
| Standard mail order | $8.00 | $20.00 | 20% | 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 | 20% | 50% | N/A |
| Preferred mail order | $0.00 | $10.00 | 17% | 50% | N/A |
| Standard mail order | $16.00 | $40.00 | 20% | 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 | 20% | 50% | N/A |
| Preferred mail order | $0.00 | $3.00 | 17% | 50% | N/A |
| Standard mail order | $24.00 | $60.00 | 20% | 50% | N/A |
Plan Documents
| Links to plan documents |
Oklahoma Counties Served
- Adair
- Alfalfa
- Atoka
- Beaver
- Beckham
- Blaine
- Bryan
- Caddo
- Canadian
- Carter
- Cherokee
- Choctaw
- Cimarron
- Cleveland
- Coal
- Comanche
- Cotton
- Craig
- Creek
- Custer
- Delaware
- Dewey
- Ellis
- Garfield
- Garvin
- Grady
- Grant
- Greer
- Harmon
- Harper
- Haskell
- Hughes
- Jackson
- Jefferson
- Johnston
- Kay
- Kingfisher
- Kiowa
- Latimer
- Le Flore
- Lincoln
- Logan
- Love
- Major
- Marshall
- Mayes
- Mcclain
- Mccurtain
- Mcintosh
- Murray
- Muskogee
- Noble
- Nowata
- Okfuskee
- Oklahoma
- Okmulgee
- Osage
- Ottawa
- Pawnee
- Payne
- Pittsburg
- Pontotoc
- Pottawatomie
- Pushmataha
- Roger Mills
- Rogers
- Sebastian
- Seminole
- Sequoyah
- Stephens
- Texas
- Tillman
- Tulsa
- Wagoner
- Washington
- Washita
- Woods
- Woodward