Pharmacy Benefits


2021 Part D Prescription Drug Coverage

Available with Quartz Medicare Advantage (HMO) Core D, Value D and Elite D plans.
 

30-day

Retail
60-Day

90-Day 

Mail Order
90-Day

 Yearly Deductible$0$0$0$0
 Tier 1 (Preferred Generic)$3$6$9 $7
 Tier 2 (Generic)$15$30$45$38
 Tier 3 (Preferred Brand)$45$90$135 $113 
 Tier 4 (Non-Preferred Drug)  40% of cost 40% of cost40% of cost40% of cost
 Tier 5 (Specialty) 30% of cost N/A N/AN/A 

 

Initial Coverage Gap begins at: $4,130
Catastrophic Coverage begins at: $6,550

Check Drug Prices and Pharmacy Network

2020 Part D Prescription Drug Coverage

 

30-day

Retail
60-Day

90-Day 

Mail Order
90-Day

 Yearly Deductible$0$0$0$0
 Tier 1 (Preferred Generic)$3$6$9 $7
 Tier 2 (Generic)$15$30$45$38
 Tier 3 (Preferred Brand)$45$90$135 $113 
 Tier 4 (Non-Preferred Drug)  40% of cost 40% of cost40% of cost40% of cost
 Tier 5 (Specialty) 33% of cost N/A N/AN/A 

 

This webpage was updated on November 9, 2020.