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Plan Details

Horizon Medicare Blue Rx Enhanced (PDP)

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MONTHLY PREMIUM

$97.40

ENROLL
BENEFIT TYPE IN NETWORK BENEFIT
Annual Deductible
Annual Deductible This plan does not have a Deductible .
Initial Coverage
Initial Coverage

Standard Pharmacy One-month supply:

  • Tier 1 (Preferred Generic): $0 Copay
  • Tier 2 (Generic): $5 Copay
  • Tier 3 (Preferred Brand): $40 Copay
  • Tier 4 (Non-Preferred Drug): 45% Copay
  • Tier 5 (Specialty Tier): 33% of the cost

Standard Mail Order Three-month supply:

  • Tier 1 (Preferred Generic): $0 Copay
  • Tier 2 (Generic): $7.50 Copay
  • Tier 3 (Preferred Brand): $120 Copay
  • Tier 4 (Non-Preferred Drug): 45% Copay
  • Tier 5 (Specialty Tier): Not offered

If you reside in a long-term facility, you pay the same as at a retail pharmacy. You may get drugs from an out-of-network pharmacy, but may pay more than you pay at an in-network pharmacy.

Coverage Gap
Coverage Gap

The Coverage Gap begins after the total yearly drug cost (including what our plan has paid and what you have paid) reaches $4,130. After you enter the Coverage Gap , you pay 25% of the plan's cost for covered brand name drugs and a $0 Copay for Tier 1 preferred generics and an $5 Copay for Tier 2 non-preferred generic drugs until your costs total $6,550.

Catastrophic Coverage
Catastrophic Coverage

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reaches $6,550, you pay the greater of:

  • 5% of the cost, or
  • $3.70 Copay for generic (including brand drugs treated as generic) and a $9.20 Copay for all other drugs.

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