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AARP Medicare Rx Preferred from UHC (PDP) - S5921-414-000
Monthly Premium
AARP Medicare Rx Preferred from UHC (PDP) is a Medicare Part D Prescription Drug Plan offered by UnitedHealthcare
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
Monthly Premium
Plan ID: S5921-414-000
Hawaii Medicare beneficiaries may want to consider reviewing their Medicare prescription drug coverage options, such as a standalone Part D prescription drug plan (PDP) or a Medicare Advantage (Medicare Part C) plan that includes drug coverage.
A Part D plan can be used alongside your Original Medicare (Part A and Part B) coverage. A Medicare Advantage plan that includes drug coverage combines your Part A, Part B and Part D benefits into a single plan
Learn more about Hawaii Medicare prescription drug plans like the one below and find a plan that offers the benefits you want at an affordable price.
AARP Medicare Rx Preferred from UHC (PDP) - S5921-414-000 Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $139.20 |
| Annual deductible | $130.00 |
| Preferred pharmacies? | Yes |
| Accepts Mail Order? | Yes |
| Star Rating | 2 out of 5 stars |
Prescription Drug Costs and Coverage
The AARP Medicare Rx Preferred from UHC (PDP) is a prescription drug plan which offers the following coverage:
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $5.00 | $10.00 |
| Standard retail | $13.00 | $18.00 |
| Preferred mail order | N/A | N/A |
| Standard mail order | N/A | N/A |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug |
|---|---|---|
| Preferred retail | $15.00 | $30.00 |
| Standard retail | $39.00 | $54.00 |
| Preferred mail order | $0.00 | $0.00 |
| Standard mail order | $39.00 | $54.00 |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug | Tier 3 Preferred Brand Drug | Tier 4 Non-Preferred Drug | Tier 5 Specialty Tier Drug |
|---|---|---|---|---|---|
| Preferred retail | $5.00 | $10.00 | 17% | 34% | 31% |
| Standard retail | $13.00 | $18.00 | 17% | 39% | 31% |
| Preferred mail order | N/A | N/A | N/A | 34% | 31% |
| Standard mail order | N/A | N/A | N/A | 39% | 31% |
| Tiers | Tier 1 Preferred Generic Drug | Tier 2 Generic Drug | Tier 3 Preferred Brand Drug | Tier 4 Non-Preferred Drug | Tier 5 Specialty Tier Drug |
|---|---|---|---|---|---|
| Preferred retail | $15.00 | $30.00 | 17% | N/A | N/A |
| Standard retail | $39.00 | $54.00 | 17% | N/A | N/A |
| Preferred mail order | $0.00 | $0.00 | 17% | N/A | N/A |
| Standard mail order | $39.00 | $54.00 | 17% | N/A | N/A |
Plan Documents
| Links to plan documents |