Extra Help is applied
Look for the green-colored pricing as you shop for plans to see your potential cost savings shown by the crossed out dollar amount.
Learn More about Extra HelpAARP Medicare Rx Saver from UHC (PDP) S5921-356-000
The information provided in this document may be subject to change over time and may become outdated. For the most current and up-to-date information, please refer to our website at UHC.com/medicare.
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Monthly premium
new former $98.70
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Estimated annual drug cost
Explore the plan details
Explore the plan details
Prescription drug benefits
Learn about this plan's costs for prescription drug coverage.
Annual prescription deductible
Retail network pharmacy (30-day supply)
Tier 1: Preferred Generic Drugs
Preferred Network
$8 copayStandard Network
Tier 2: Generic Drugs
Preferred network
$10 copayStandard network
Tier 3: Preferred Brand Drugs
Preferred network
18% of the costStandard network
Tier 3: Insulin
Preferred network
Up to $35 copayStandard network
Tier 4: Non-Preferred Drugs
Preferred network
38% of the costStandard network
Tier 5: Specialty Drugs
Preferred network
25% of the costStandard network
Mail order pharmacy
Tier 1: Preferred Generic Drugs
Tier 2: Generic Drugs
Tier 3: Preferred Brand Drugs
Tier 3: Insulin
Cost shares if you receive Extra Help
Brand Drugs
Generic Drugs
Cost shares if you receive Extra Help
Brand Drugs
Generic Drugs
Cost shares if you receive Extra Help
Brand Drugs
Generic Drugs
Cost shares if you receive Extra Help
Brand Drugs
Generic Drugs
Plan documents
Important documents that provide the details you need about this plan's coverage and benefits, prescription drugs, enrollment, providers and more.
General Plan Information
Prescription Drug Coverage
Footnotes & disclaimers
Disclaimer information
Enrollment Disclaimer Information:
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and/or Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. For Dual Special Needs Plans: A Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.
AARP-related Disclaimer:
UnitedHealthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to enroll in a Medicare Advantage or Prescription Drug Plan. AARP encourages you to consider your needs when selecting products and does not make specific product recommendations for individuals. AARP does not employ or endorse agents, producers or brokers.
Limited Access:
AARP® Medicare Rx Preferred from UHC (PDP)’s and AARP® Medicare Rx Saver from UHC (PDP)’s pharmacy network includes limited lower-cost pharmacies in rural MT, NE, ND, SD and WY. There are an extremely limited number of preferred cost share pharmacies in suburban MT. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call us or consult the online pharmacy directory.
Extra Help:
If you are receiving Extra Help from Medicare, your copays may be lower or you may have no copays.
The Medicare Prescription Payment Plan:
If you have high out-of-pocket costs for your covered Part D prescription drugs each year, you may want to participate in the Medicare Prescription Payment Plan. This payment plan spreads your out-of-pocket prescription drug costs over the remainder of the calendar year. Learn more about the Medicare Prescription Payment Plan.
Other Languages:
This information is available for free in other languages. Please contact Customer Service for additional information.
Esta información está disponible sin costo en otros idiomas. Para obtener más información comuníquese con nuestro Servicio al Cliente.
本資訊可以其他語言免費提供。如需更多資訊,請聯絡客戶服務部。