Cigna Healthcare Extra Rx: Part D Plan S5617-253 Details for North Carolina
We partner with HealthCompare for some plans. Compensation does not influence our content. Learn more.
Cigna Healthcare Extra Rx is a 2025 Medicare Part D plan from Cigna Healthcare that's available to individuals enrolled in a Medicare Advantage plan without prescription drug plan benefits or Medicare Part A and/or Part B
This Part D plan has a monthly premium of $102.30, an initial coverage limit of $2,000, and a $175.00 deductible that must be paid at the pharmacy before cost-sharing begins. *CMS rated this plan 2.5 (Below Average) out of 5 stars.
See more Medicare Part D Plans in North Carolina.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5617-253 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $102.30/mo |
| Deductible: | $175.00/yr |
| Benefit Type: | Enhanced |
| Low Income Subsidy: | Yes |
| Availability: | North Carolina |
| Insured By: | Cigna Healthcare |
Prescription Drug Premium with Extra Help
Although Cigna Healthcare Extra Rx's monthly premium is bundled with the total plan cost, some plans may receive low-income subsidy (LIS) assistance known as Extra Help. The following table outlines the LIS available through this Cigna Healthcare plan (if any).
| Low Income Premium Subsidy: | $51.22 |
| Low Income Premium Subsidy CMS Pays: | $51.20 |
| Low Income Subsidy Premium: | $51.10 |
The Social Security Extra Help page has more information about the Low-Income Subsidy (“Extra Help”) program.
Prescription Drug Plan Deductible
This plan's Medicare Part D annual deductible is $175.00. You must pay this amount at the pharmacy before Cigna Healthcare begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Cigna Healthcare Extra Rx has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic* | $1.00 | $11.00 | |
| Generic* | $8.00 | $20.00 | |
| Preferred Brand | 19.00% | 23.00% | |
| Non-Preferred Drug | 50.00% | 50.00% | |
| Specialty Tier | 31.00% | 31.00% | |
| *Deductible does not apply. | |||
2025 CMS Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0. Here are the most recent CMS ratings for this plan.
| CMS Measure | Star Rating |
|---|---|
| Overall Plan Rating | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Every plan covers drugs differently, so it's important to look at your total cost.
Contact Us About Cigna Healthcare
| Plan Website: | Cigna Healthcare |
|---|---|
| Formulay Information: | Cigna Healthcare Formulary Information |
| Pharmacy Information: | Cigna Healthcare Pharmacy Information |
| Prospective Part D Members: | (800)735-1459 |
| Prospective Part D TTY Users: | (877)843-6493 |
If you qualify for Original Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program at www.medicare.gov.
Citations & References
- Cigna Healthcare, "http://www.cignamedicare.com", Last Accessed March 1, 2025
- Medicare.gov, "Explore your Medicare coverage options", Last Accessed March 2, 2024
- Medicare.gov, "How Part D works with other insurance", Last Accessed March 14, 2024
- Medicare.gov, "Costs for Medicare drug coverage", Last Accessed March 3, 2024
- SSA.gov, "Understanding the Extra Help With Your Medicare", Last Accessed March 9, 2024
- CMS.gov, "Landscape Source Files", Last Accessed March 1, 2025
- CMS.gov, "Medicare Part C & D Performance", Last Accessed March 1, 2025
- CMS.gov, "Benefits Data", Last Accessed March 1, 2025
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.