Clear Spring Health Premier Rx (PDP)


Medicare Plan Details

2022 Plan
Monthly Premium
(select county for price)

 

by Clear Spring Health
Additional Coverage

(none)

Overall Government Star Rating
 2.0
out of 5 stars

State: Oklahoma

Select your county to view the price for this plan

 


Plan Type

Prescription Drug (Part D)

 

$16
$480.00
No

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$15.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$3.95 copay or 5% (whichever costs more)

Brand-name drugs :
$9.85 copay or 5% (whichever costs more)

Generic$20.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug50%
Specialty Tier25%

Part B Drugs

Not covered
Not covered
 2
 1
 1
 4
 2

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