2024 MEDICARE PART D STAND-ALONE PRESCRIPTION DRUG PLANS IN NEW JERSEY
Company Name Plan Name
Benefit Type
Premium
with
Medicaid
or
LIS/Extra
Help
2024
Premium
Annual Drug
Deductible
Additional
Coverage
Offered in the
Gap
Contract ID
Plan ID
Plan's Performance
Rating*
$0 premium with
NJ PAAD
Preferred
Pharmacy
Chains
**
AARP Medicare Rx Walgreens
from UHC
Enhanced
$8.70
$54.20
$410
$0 deduct
for Tier 1
drugs
Covers Tier 1 in
the Gap
S5921 386
3
stars
PAAD
pays the
premium
and
enrolls
Walgreens and
Mail Order
AARP Medicare Rx Basic
from UHC
(formerly called AARP Medicare Rx Saver)
Basic
$22.90
$68.40
$545
No Additional
Gap Coverage
S5921 349
3
stars
PAAD
pays the
premium
and
enrolls
Walgreens,
Walmart and
Mail order
AARP Medicare Rx Preferred
from UHC
Enhanced
$60.50
$106.00
$0
No Additional
Gap Coverage
S5820 003
3.5
stars
Walgreens,
Walmart and
Mail order
Cigna Saver Rx
Enhanced
$15.80
$16.80
$545
$0 deduct
for Tier 1 &
Tier 2
drugs
No Additional
Gap Coverage
S5617 354
2.5
stars
PAAD
pays the
premium
and
enrolls
Rite Aid,
Walgreens,
Walmart,
Mail Order
Cigna Extra Rx
Enhanced
$56.90
$102.40
$145
$0 deduct
for Tiers
1, 2, 3
Covers Tiers 1
& 2 in the Gap
S5617 249
2.5
stars
Rite Aid,
Walgreens,
Walmart,
Mail Order
Cigna Secure Rx
Basic
$15.10
$60.60
$545
No Additional
Gap Coverage
S5617 018
2.5
stars
PAAD
pays the
premium
and
enrolls
Rite Aid,
Walgreens,
Walmart,
Mail Order
Clear Spring Health
1-877-317-6082
clearspringhealthcare.com
Clear Spring Health Value Rx
Sanctioned by CMS, cannot take new
members. Current members can
switch to another plan anytime in
2024.
Basic
$0
$24.30
$545
No Additional
Gap Coverage
S6946 001
1.5
stars
Low
Performing
Plan
CVS, Rite Aid,
Walmart, Mail
Order
**Plans work with many pharmacies, but offer two pricing structures: one for "standard" network pharmacies and another for "preferred" network pharmacies. You will pay
the plan's standard copays at in-network pharmacies and reduced copays at preferred pharmacies within your plan's network. This column shows chain stores where
preferred pricing is available for each plan. Many independent pharmacies and grocery store pharmacies may also offer preferred pricing for your plan. Check with your
plan and/or pharmacy.
Cigna
1-800-735-1459
cignamedicarerx.com
National Plan
Data as of November 6, 2023
UnitedHealthcare
1-888-867-5564
aarpmedicarerx.com
National Plan
* Plan's Overall Performance Rating determined by Medicare and based on 2023 performance. Rating range is 1 to 5 stars, with 5 being the highest rating. Plan with Low Performing
indicator has low ratings for three years in a row
Plans in yellow have $0 premium for those with Medicaid or Low Income Subsidy (also known as "Extra Help"). All yellow plans are referred to as "benchmark" plans.
Page 1 of 3
2024 MEDICARE PART D STAND-ALONE PRESCRIPTION DRUG PLANS IN NEW JERSEY
Company Name Plan Name
Benefit Type
Premium
with
Medicaid
or
LIS/Extra
Help
2024
Premium
Annual Drug
Deductible
Additional
Coverage
Offered in the
Gap
Contract ID
Plan ID
Plan's Performance
Rating*
$0 premium with
NJ PAAD
Preferred
Pharmacy
Chains
**
UnitedHealthcare
1-888-867-5564
aarpmedicarerx.com
National Plan
Horizon Medicare Blue Rx
Standard
Basic
$19.30
$64.80
$545
No Additional
Gap Coverage
S5993 001
2.5
stars
PAAD
pays the
premium
and
enrolls
Horizon Medicare Blue Rx
Enhanced
Enhanced
$85.30
$130.80
$0
Covers Tiers 1
& 2 in the Gap
S5993 003
2.5
stars
Humana Walmart Value Rx Plan
Enhanced
$4.10
$47.60
$545
$0 deduct
for
Tiers 1 & 2
Covers Tiers 1
& 2 in the Gap
S5884
183
3
stars
PAAD
pays the
premium
but cannot
enroll
Walmart and Mail
Order
Humana Basic Rx Plan
Basic
$13
$58.50
$545
No Additional
Gap Coverage
S5884
131
3
stars
PAAD
pays the
premium
but cannot
enroll
Humana Premier Rx Plan
Enhanced
$61.60
$107.10
$200
$0 deduct
for
Tiers 1, 2
& 6
Covers Tiers 1
& 2 in the Gap
S5884
150
3
stars
Mutual of Omaha Rx Essential
Enhanced
$24.40
$24.40
$545
$0 deduct
for Tier 1
No Additional
Gap Coverage
S7126 106
1.5
stars
CVS, Rite Aid,
Walmart,
Mail Order
Mutual of Omaha Rx Premier
Enhanced
$44.00
$89.50
$349
$0 deduct
for Tiers 1
& 2
No Additional
Gap Coverage
S7126 073
1.5
stars
CVS, Rite Aid,
Walmart,
Mail Order
Mutual of Omaha Rx Plus
Basic
$52.50
$98.00
$545
No Additional
Gap Coverage
S7126 003
1.5
stars
CVS, Rite Aid,
Walmart,
Mail Order
Horizon Blue Cross
Blue Shield of NJ
1-888-765-7134
horizonblue.com
Humana Insurance
1-800-706-0872
humana-medicare.com
National Plan
Mutual of Omaha Rx
1-800-961-9006
mutualofomaharx.com
Mail Order only
Preferred
Pharmacy.
Standard pricing
at all in-network
retail pharmacies
Mail Order only
Preferred
Pharmacy.
Standard pricing
at all in-network
retail pharmacies
Page 2 of 3
2024 MEDICARE PART D STAND-ALONE PRESCRIPTION DRUG PLANS IN NEW JERSEY
Company Name Plan Name
Benefit Type
Premium
with
Medicaid
or
LIS/Extra
Help
2024
Premium
Annual Drug
Deductible
Additional
Coverage
Offered in the
Gap
Contract ID
Plan ID
Plan's Performance
Rating*
$0 premium with
NJ PAAD
Preferred
Pharmacy
Chains
**
UnitedHealthcare
1-888-867-5564
aarpmedicarerx.com
National Plan
SilverScript SmartSaver
Enhanced
$2.30
$12.40
$280
$0 deduct
for Tier 1
No Additional
Gap Coverage
S5601
179
3
stars
PAAD
pays the
premium
and
enrolls
CVS, Walmart,
Mail Order
(CANNOT use
Walgreens)
SilverScript Choice
Basic
$7.60
$53.10
$545
No Additional
Gap Coverage
S5601
008
3
stars
PAAD
pays the
premium
and
enrolls
CVS,
Walmart, Mail
Order
SilverScript Plus
Enhanced
$58.10
$93.60
$200
$0 deduct
for
Tier 1 & 2
Covers Tiers 1
& 2 in the Gap
S5601 009
3
stars
CVS,
Walmart, Mail
Order
WellCare Value Script
Enhanced
$0 $0
$545 $0
deduct for
Tiers 1 & 2
No Additional
Gap Coverage
S4802 139
3.5
stars
PAAD
pays the
premium
and
enrolls
CVS, Walgreens,
Mail Order
WellCare Classic
Basic
$0
$35.20
$545
No Additional
Gap Coverage
S4802 078
3.5
stars
PAAD
pays the
premium
and
enrolls
CVS, Walgreens,
Mail Order
Wellcare Medicare Rx
Value Plus
Enhanced
$46.50
$79.00
$0
No Additional
Gap Coverage
S4802 207
3.5
stars
CVS, Walgreens,
Mail Order
Prepared by the State Health Insurance Assistance Program (SHIP), in the Division of Aging Services, NJ Department of Human Services.
*Plan's Overall Performance Rating determined by Medicare and based on 2023 performance. Rating range is 1 to 5 stars, with 5 being the highest rating.
Plans in yellow have $0 premium for those with Medicaid, or Low Income Subsidy (also known as "Extra Help"). All yellow plans are referred to as "benchmark" plans.
Aetna Medicare
1-833-526-2445
aetnamedicare.com
National Plan
Wellcare
1-866-859-9084
wellcare.com/pdp
National Plan
For assistance in choosing a Medicare Part D Drug Plan, call the NJ State Health Insurance Assistance Program (SHIP) at 1-800-792-
8820
or call 1-800-Medicare.
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