Cigna Healthcare Extra Rx Part D Plan S5617-251 Details for Pennsylvania
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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 plan has a monthly premium of $95.30, an initial coverage limit of $5,030, an out-of-pocket threshold of $8,000, and a $175.00 deductible that must be paid before cost-sharing begins. *This plan has an overall rating of 2.5 (Below Average) out of 5 stars.
See more Medicare Part D Plans in Pennsylvania.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S5617-251 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $95.30/mo |
| Deductible: | $175.00/yr |
| Benefit Type: | Enhanced |
| Low Income Subsidy: | Yes |
| Availability: | Pennsylvania |
| Insured By: | Cigna Healthcare |
Prescription Drug Plan Premium
Although Cigna Healthcare Extra Rx 's monthly premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the premium details of this Cigna Healthcare plan.
| Basic Part D Premium: | $65.10 |
| Supplemental Part D Premium: | $30.20 |
| Total Part D Premium: | $95.30 |
| Low Income Premium Subsidy: | $48.36 |
| Low Income Premium Subsidy CMS Pays: | $48.40 |
| Low Income Subsidy Premium: | $46.90 |
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 | $12.00 | |
| Generic* | $9.00 | $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
The following table shows the quality ratings for this Cigna Healthcare plan. Each year 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.
| 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 |
The true value of any Medicare Part D plan can only be judged by how well it covers your medications.
Contact 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 October 13, 2024
- Medicare.gov, "Explore your Medicare coverage options", Last Accessed March 2, 2024
- Medicare.gov, "What Medicare Part D drug plans cover", Last Accessed March 1, 2024
- Medicare.gov, "Costs for Medicare drug coverage", Last Accessed March 3, 2024
- Medicare.gov, "Help with drug costs", Last Accessed February 19, 2024
- CMS.gov, "Landscape Source Files", Last Accessed October 3, 2024
- CMS.gov, "Medicare Part C & D Performance", Last Accessed October 11, 2024
- CMS.gov, "Benefits Data", Last Accessed October 9, 2024
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.