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Cigna Healthcare Saver Rx (PDP) - S5617-377-000
$20.70
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.
$20.70
Monthly Premium
Colorado 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 Colorado 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) - S5617-377-000 Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $20.70 |
| 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 | $10.00 | $20.00 |
| Preferred mail order | $0.00 | $5.00 |
| Standard mail order | $10.00 | $20.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $10.00 |
| Standard retail | $20.00 | $40.00 |
| Preferred mail order | $0.00 | $10.00 |
| Standard mail order | $20.00 | $40.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $0.00 | $15.00 |
| Standard retail | $30.00 | $60.00 |
| Preferred mail order | $0.00 | $3.00 |
| Standard mail order | $30.00 | $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 | 18% | 50% | 25% |
| Standard retail | $10.00 | $20.00 | 24% | 50% | 25% |
| Preferred mail order | $0.00 | $5.00 | 18% | 50% | 25% |
| Standard mail order | $10.00 | $20.00 | 24% | 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 | 18% | 50% | N/A |
| Standard retail | $20.00 | $40.00 | 24% | 50% | N/A |
| Preferred mail order | $0.00 | $10.00 | 18% | 50% | N/A |
| Standard mail order | $20.00 | $40.00 | 24% | 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 | 18% | 50% | N/A |
| Standard retail | $30.00 | $60.00 | 24% | 50% | N/A |
| Preferred mail order | $0.00 | $3.00 | 18% | 50% | N/A |
| Standard mail order | $30.00 | $60.00 | 24% | 50% | N/A |
Plan Documents
| Links to plan documents |
Colorado Counties Served
- Adams
- Alamosa
- Arapahoe
- Archuleta
- Baca
- Bent
- Boulder
- Broomfield
- Chaffee
- Cheyenne
- Clear Creek
- Colfax
- Conejos
- Costilla
- Crowley
- Custer
- Delta
- Denver
- Deuel
- Dolores
- Douglas
- Eagle
- El Paso
- Elbert
- Fremont
- Garfield
- Gilpin
- Grand
- Gunnison
- Hinsdale
- Huerfano
- Jackson
- Jefferson
- Kiowa
- Kit Carson
- La Plata
- Lake
- Larimer
- Las Animas
- Lincoln
- Logan
- Mesa
- Mineral
- Moffat
- Montezuma
- Montrose
- Morgan
- Otero
- Ouray
- Park
- Phillips
- Pitkin
- Prowers
- Pueblo
- Rio Blanco
- Rio Grande
- Routt
- Saguache
- San Juan
- San Miguel
- Sedgwick
- Summit
- Teller
- Washington
- Weld
- Yuma